Individual
JOHN KEN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
450 W HIGHWAY 22, BARRINGTON, IL 60010-7509
(847) 381-9600
Mailing address
8135 N MILWAUKEE AVE, NILES, IL 60714-2828
(847) 967-8098
(847) 967-8594
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036113245
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036113245
—
IL
01
—
04932448
BLUE SHIELD OF ILLINOIS
IL
Enumeration date
07/18/2005
Last updated
12/22/2021
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