Individual
DR. LEE JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
675 W NORTH AVE, SUITE 408, MELROSE PARK, IL 60160-1634
(708) 450-4950
(708) 343-8505
Mailing address
675 W NORTH AVE, SUITE 408, MELROSE PARK, IL 60160-1634
(708) 450-4950
(708) 343-8505
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036088632
IL
208600000X
Surgery Physician
036088632
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036088632
—
IL
Enumeration date
06/12/2006
Last updated
11/24/2020
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