Organization
DEKALB CLINIC CHARTERED
Active
Organization
DEKALB CLINIC CHARTERED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM K LEE M.D. (CHAIRMAN, BOARD OF DIRECTORS)
(815) 758-8671
Entity
Organization
Contact information
Practice address
165 E PLANK RD, SYCAMORE, IL 60178-8757
(815) 758-8671
(815) 758-1731
Mailing address
217 FRANKLIN ST, DEKALB, IL 60115-3742
(815) 758-8671
(815) 758-1731
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
Other
Enumeration date
07/17/2006
Last updated
10/26/2007
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