Individual
KEW-JUNG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
830 W DIVERSEY PKWY, CHICAGO, IL 60614-1454
(773) 281-3563
(773) 880-6051
Mailing address
830 W DIVERSEY PKWY, CHICAGO, IL 60614-1454
(773) 281-3563
(773) 880-6051
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-091450
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091450
—
IL
Enumeration date
10/31/2005
Last updated
02/05/2014
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