Individual
GLENDA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8905 W LINCOLN AVE, STE. 407, WEST ALLIS, WI 53227-2468
(414) 545-8808
(414) 545-4920
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
27018
WI
207VG0400X
Gynecology Physician
Primary
27018
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31434300
—
WI
01
—
32832400
GROUP MEDICAID
WI
Enumeration date
02/17/2006
Last updated
09/25/2023
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