Individual
JOHNNY KEITH LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 E ERIE ST, SUITE 300, CHICAGO, IL 60611-2740
(312) 649-3939
Mailing address
1 E ERIE ST, SUITE 300, CHICAGO, IL 60611-2740
(312) 649-3939
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036128126
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036128126
ILLINOIS DEPT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
09/24/2008
Last updated
10/04/2011
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