MEDICARE: MASTER LEE'S ACUPUNCTURE INC.

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	171100000X	Acupuncturist	198000749	IL

General Provider Information

NPI Number	:	1316218555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MASTER LEE'S ACUPUNCTURE INC.

Provider Business Mailing Address
First Line	:	3207 LAKE AVE
Second Line	:	UNIT 9B
City	:	WILMETTE
State	:	IL
Zip	:	60091-1082
Country	:	US
Telephone Number	:	847-920-9904
Fax Number	:

Provider Business Practice Location Address
First Line	:	3207 LAKE AVE
Second Line	:	UNIT 9B
City	:	WILMETTE
State	:	IL
Zip	:	60091-1082
Country	:	US
Telephone Number	:	847-920-9904
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. HOON LEE
Credential	:
Telephone Number	:	847-920-9904

Provider Enumeration Date	:	01/19/2012
Last Update Date	:	01/19/2012

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