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General NPI Number Information
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NPI Number | 1962442160
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Entity Type | Individual
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Provider Name | KRISTIN J LEE MD
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Gender | Female
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 1725 W HARRISON ST STE 1017
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City | CHICAGO
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State | IL
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Zip | 60612-3896
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Country | US
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Telephone | 312-563-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 55 W CHESTNUT ST APT 2408
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City | CHICAGO
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State | IL
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Zip | 60610-7316
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA07954500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036115584
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License Number State | IL
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