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General NPI Number Information
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NPI Number | 1215951488
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Entity Type | Individual
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Provider Name | LEE I HUANG MD
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 729 BROADWAY ST
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City | QUINCY
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State | IL
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Zip | 62301-2708
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Country | US
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Telephone | 217-228-0252
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Fax | 217-228-3143
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Provider Business Mailing Address
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Address Line | 729 BROADWAY ST
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City | QUINCY
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State | IL
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Zip | 62301-2708
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Country | US
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Telephone | 217-228-0252
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Fax | 217-228-3143
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 036053121
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License Number State | IL
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