Individual
DR. MICHAEL JAE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
676 N SAINT CLAIR ST, SUITE 2010, CHICAGO, IL 60611-2922
(312) 926-5800
(312) 926-6190
Mailing address
676 N SAINT CLAIR ST, SUITE 2010, CHICAGO, IL 60611-2922
(312) 926-5800
(312) 926-6190
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
036102034
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K47967
MEDICARE PTAN
IL
Enumeration date
10/04/2005
Last updated
01/22/2013
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