Basic Information
| Provider Information | |||||||||
| NPI: | 1720382856 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALKUREISHI | ||||||||
| FirstName: | LEE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MBCHB | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2211 N OAK PARK AVE | ||||||||
| Address2: | SECTION OF PLASTIC AND RECONSTRUCTIVE SURGERY | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 607073351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7736225400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2211 N OAK PARK AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 607073351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7736225400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2011 | ||||||||
| LastUpdateDate: | 10/04/2015 | ||||||||
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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 | 208200000X | 125-056-251 | IL | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.