Organization
JENNIFER S LEE MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER S LEE MD (OWNER/PRESIDENT)
(217) 523-0808
Entity
Organization
Contact information
Practice address
320 E CARPENTER ST, SPRINGFIELD, IL 62702-5185
(217) 523-0808
(217) 523-9859
Mailing address
320 E CARPENTER ST, SPRINGFIELD, IL 62702-5185
(217) 523-0808
(217) 523-9859
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
036119974
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036119974
ILLINOIS PROFESSIONAL LICENSE NUMBER
IL
Enumeration date
05/29/2008
Last updated
05/29/2008
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