Individual
MR. CHARLES C LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
20 E NORTHWEST HWY, MT PROSPECT, IL 60056-3223
(847) 342-9033
(847) 255-8441
Mailing address
20 E NORTHWEST HWY, MT PROSPECT, IL 60056-3223
(847) 342-9033
(847) 818-8111
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038007948
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001622195
BLUE CROSS BLUE SHIELD
IL
Enumeration date
12/15/2006
Last updated
06/26/2015
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