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Individual

LEE MICHAEL DE DORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
25 N WINFIELD ROAD, SUITE 505, WINFIELD, IL 60190
(630) 682-5653
(630) 682-8946
Mailing address
1 WESTBROOK CORPORATE CTR, STE 240, WESTCHESTER, IL 60154-5745
(630) 682-5653
(630) 682-8946

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085003692
IL

Other

Enumeration date
02/11/2010
Last updated
06/16/2017
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