Organization
JOHN C. LEE, M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN C LEE M.D. (PHYSICIAN)
(217) 423-9000
Entity
Organization
Contact information
Practice address
1714 S BLAINE LN, DECATUR, IL 62521-5025
(217) 423-9000
(217) 423-9002
Mailing address
1714 S BLAINE LN, DECATUR, IL 62521-5025
(217) 423-9000
(217) 423-9002
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036052344
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005800230
BCBS
IL
05
—
036052344
—
IL
Enumeration date
07/16/2008
Last updated
07/16/2008
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