MEDICARE: DONALD LEI MD

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	207N00000X	Dermatology Physician	036-174245	IL

General Provider Information

NPI Number	:	1497331201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD LEI MD

Provider Business Mailing Address
First Line	:	1625 N HARLEM AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60707-4303
Country	:	US
Telephone Number	:	312-947-7546
Fax Number	:

Provider Business Practice Location Address
First Line	:	1625 N HARLEM AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60707-4303
Country	:	US
Telephone Number	:	312-947-7546
Fax Number	:

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

Provider Enumeration Date	:	03/22/2021
Last Update Date	:	07/08/2025

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