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NPI Code Detail

MEDICARE: PETER LEE

MEDICARE: PETER LEE
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
1183500000XPharmacist051.297788IL

General Provider Information

NPI Number : 1750783098
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER LEE
Provider Business Mailing Address
First Line : 3232 LAKE AVE
Second Line :
City : WILMETTE
State : IL
Zip : 60091-1073
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3232 LAKE AVE
Second Line :
City : WILMETTE
State : IL
Zip : 60091-1073
Country : US
Telephone Number : 847-251-1413
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2014
Last Update Date : 09/18/2014

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Directions to “ PETER LEE ” Practice Location

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