MEDICARE: CATHERINE LEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	201.022209	IL

General Provider Information

NPI Number	:	1346840337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE LEE

Provider Business Mailing Address
First Line	:	2720 S RIVER RD STE 128
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60018-4110
Country	:	US
Telephone Number	:	847-306-7277
Fax Number	:

Provider Business Practice Location Address
First Line	:	2720 S RIVER RD STE 128
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60018-4110
Country	:	US
Telephone Number	:	847-877-4563
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2020
Last Update Date	:	09/29/2021

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Directions to “ CATHERINE LEE ” Practice Location

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