Individual
DR. THOMAS GREGORY LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
6915 N KNOXVILLE AVE STE 1, PEORIA, IL 61614-2851
(309) 691-1259
(309) 683-8911
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-087310
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007223615
BCBS PROVIDER ID#
IL
01
—
023867
HEALTH ALLIANCE PROVIDER
IL
05
—
036087310
—
IL
01
—
291798
HEALTHLINK PROVIDER ID#
IL
01
—
IL0101
JOHN DEERE PROVIDER ID#
IL
Enumeration date
07/20/2006
Last updated
12/04/2025
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