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General NPI Number Information
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NPI Number | 1093001950
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Entity Type | Organization
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Legal Business Name | HONG LEE INC
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 06/20/2011
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Provider Practice Location Address
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Address Line | 1138 W JEFFERSON ST
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City | SHOREWOOD
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State | IL
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Zip | 60404-0703
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Country | US
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Telephone | 815-744-2244
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Fax |
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Provider Business Mailing Address
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Address Line | 20528 MCGILVRAY DR
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City | CREST HILL
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State | IL
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Zip | 60403-2060
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Country | US
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Telephone | 469-789-4940
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. HONG TAI LEE
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Credential | D.C.
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Telephone | 469-789-4940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038.011655
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License Number State | IL
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