Organization
SUBURBAN RADIOLOGISTS, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT KWAN LEE MD (PRESIDENT)
(630) 581-6504
Entity
Organization
Contact information
Practice address
5101 S. WILLOW SPRINGS RD, LAGRANGE, IL 60525-2600
(630) 581-6504
Mailing address
1446 MOMENTUM PLACE, CHICAGO, IL 60689-5314
(630) 581-6504
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2215114
BCBS
IL
01
—
CF8050
MEDICARE RAILROAD
IL
Enumeration date
07/22/2006
Last updated
09/12/2019
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