MEDICARE: LISA BROWN LEE M.S. CCC/SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP8281	OH
2	235Z00000X	Speech-Language Pathologist	146.009748	IL

General Provider Information

NPI Number	:	1225271851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA BROWN LEE M.S. CCC/SLP

Provider Business Mailing Address
First Line	:	1941 N MOHAWK ST APT 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-8971
Country	:	US
Telephone Number	:	313-410-7321
Fax Number	:

Provider Business Practice Location Address
First Line	:	4866 W BALMORAL AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-1504
Country	:	US
Telephone Number	:	313-410-7321
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2009
Last Update Date	:	12/04/2009

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Directions to “ LISA BROWN LEE M.S. CCC/SLP” Practice Location

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