MEDICARE: MICHELLE SUNWOO 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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	26029163A	IN

General Provider Information

NPI Number	:	1366105314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE SUNWOO LEE

Provider Business Mailing Address
First Line	:	716 N NILES AVE APT 1023
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46617-1924
Country	:	US
Telephone Number	:	312-714-5826
Fax Number	:

Provider Business Practice Location Address
First Line	:	1217 E IRELAND RD
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46614-3497
Country	:	US
Telephone Number	:	574-291-0740
Fax Number	:

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

Provider Enumeration Date	:	10/18/2021
Last Update Date	:	10/18/2021

Similar Medicare Providers

1184551749 — JOSLYN KEENER
Practice Location Address:

4107 10TH ST STE B
GREAT BEND, KS
67530-3497

Practice Phone: 620-792-5944
Practice Fax:

1447731526 — QUINCEY MATSUE SIGONA
Practice Location Address:

1182 SE CENTENNIAL CT
BEND, OR
97702-3497

Practice Phone: 408-710-2658
Practice Fax:

1780254417 — KELLY ELIZABETH SHEETS LPC-MHSP
Practice Location Address:

61594 ELDERBERRY LN
SOUTH BEND, IN
46614-5810

Practice Phone: 276-469-5134
Practice Fax:

1598593287 — ESTHER POKUAA ADU NP
Practice Location Address:

1950 RIDGEDALE RD
SOUTH BEND, IN
46614-2243

Practice Phone: 574-291-6722
Practice Fax:

1265369243 — ASHLEY NANCE
Practice Location Address:

1827 E IRELAND RD
SOUTH BEND, IN
46614-2845

Practice Phone: 574-387-4313
Practice Fax:

1225031925 — DR. ROBERT DM LEE M.D.
Practice Location Address:

2102 E INWOOD RD
SOUTH BEND, IN
46614-2443

Practice Phone: 574-299-2400
Practice Fax: 574-299-2410

Directions to “ MICHELLE SUNWOO LEE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.