Individual
SUNYANG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6742 N FROSTWOOD PKWY, PEORIA, IL 61615-2402
(309) 692-5393
(309) 683-9998
Mailing address
661 HARDING RD APT 210C, MORTON, IL 61550-0515
(417) 379-6991
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
2016006196
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
209030033
IL
Other
Enumeration date
07/24/2023
Last updated
09/06/2024
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