Individual
DR. LEE S BRAAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1015 W LAWRENCE AVE, CHICAGO, IL 60640-5017
(773) 275-1835
Mailing address
1015 W LAWRENCE AVE FL 2, CHICAGO, IL 60640-5017
(773) 754-4974
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.030576
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019030576
—
IL
Enumeration date
06/17/2015
Last updated
09/08/2021
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