Basic Information
| Provider Information | |||||||||
| NPI: | 1275601973 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | SEUNG | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2421 DORINA DRIVE | ||||||||
| Address2: | |||||||||
| City: | NORTHFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60093 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8474417494 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2233 WEST DIVISION STREET | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3127702000 | ||||||||
| FaxNumber: | 3127702088 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | IL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.