Healthcare Provider Details

I. General information

NPI: 1710810866
Provider Name (Legal Business Name): ERIK LEE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SUE CHA

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5451 ARTHUR RD
SLINGER WI
53086-9531
US

IV. Provider business mailing address

5451 ARTHUR RD
SLINGER WI
53086-9531
US

V. Phone/Fax

Practice location:
  • Phone: 262-290-0095
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: