Individual
THERESA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
430 WARRENVILLE RD STE 310, LISLE, IL 60532-1348
(630) 791-1700
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036108861
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036108861
—
IL
Enumeration date
03/01/2006
Last updated
02/03/2021
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