Physician Compare National (NPI:1558347310)

HEALTHCARE PROVIDER: JI P LEE MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1558347310
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4789588682
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080602000619
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LI
	Individual professional last name
Provider First Name	JI
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	PAIN MANAGEMENT
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ANESTHESIOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ANESTHESIOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1015 S MERCER AVE
	Group Practice or individual's line 1 address
City	BLOOMINGTON
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	617017107
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140127
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ADVOCATE BROMENN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140162
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST JOSEPH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	140161
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SAINT JAMES HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y