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General NPI Number Information
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NPI Number | 1558974972
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Entity Type | Individual
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Provider Name | JAMES LEE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/25/2020
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Last Update Date | 08/25/2020
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Provider Practice Location Address
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Address Line | 1649 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60657-3017
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Country | US
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Telephone | 773-281-8439
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Fax |
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Provider Business Mailing Address
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Address Line | 901 S ASHLAND AVE APT 1008
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City | CHICAGO
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State | IL
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Zip | 60607-4091
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Country | US
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Telephone | 206-777-5982
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051301654
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License Number State | IL
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