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General NPI Number Information
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NPI Number | 1073208708
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Entity Type | Individual
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Provider Name | RYAN NEWMAN LEE DDS
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Gender | Male
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 2062 N MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60647-4002
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Country | US
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Telephone | 312-996-7555
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 W MONROE ST UNIT 402A
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City | CHICAGO
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State | IL
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Zip | 60607-1547
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Country | US
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Telephone | 346-234-4224
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 019.036116
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License Number State | IL
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