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Individual

AMANDA M. LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, PNP-BC

Contact information

Practice address
1817 S LOOMIS ST, CHICAGO, IL 60608-3018
(312) 666-6511
(312) 666-1658
Mailing address
1817 S LOOMIS ST, CHICAGO, IL 60608-3018
(312) 666-6511
(312) 666-1658

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209009815
IL

Other

Enumeration date
11/01/2012
Last updated
01/14/2013
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