Individual
THOMAS J LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
675 N SAINT CLAIR ST, GALTER 17-250, CHICAGO, IL 60611-5975
(312) 695-4837
(312) 695-0042
Mailing address
680 N LAKE SHORE DR, SUITE 1000, CHICAGO, IL 60611-4546
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036104787
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036104787
—
IL
01
—
P00652606
RR MEDICARE
IL
Enumeration date
07/07/2006
Last updated
08/03/2015
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