NPIMap

Individual provider Active NPI

Douglas A Lee, MD

  • Specialist
  • Oak Lawn, IL
National Provider Identifier
1144229949
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036-087086 Issued in IL
Practice address
9921 Southwest Hwy
Oak Lawn, IL 60453-3767
Phone
(708) 499-5678
Fax
(708) 499-5685
NPI assigned
Jul 14, 2005
Last updated
Jan 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036-087086 IL Primary

Addresses

Primary practice location

9921 Southwest Hwy
Oak Lawn, IL 60453-3767

Mailing address

9921 Southwest Hwy
Oak Lawn, IL 60453-3767
Phone (708) 499-5678

Other identifiers 2

IdentifierTypeStateIssuer
100012000OtherILMEDICARE, RRM
1622260OtherILBCBS IL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050915000483 IL Practitioner - Gastroenterology 3375576705 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Northwestern University Feinberg Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gi Partners of Illinois PLLCGroup PAC ID 2567758295, 38 clinicians

Practice addresses (Care Compare)

9921 Southwest Hwy
Oak Lawn, IL 60453-3754
Phone (708) 499-5678

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy324
Upper gastrointestinal (GI) endoscopy for acid reflux189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-087086ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Gastroenterology SC CurrentSince Apr 28, 2022 Accepting new patients
Southwest Gastroenterology, S.C. CurrentSince Nov 1, 2008 Accepting new patients
New Lenox Anesthesia LLC PastSince Jun 1, 2018 Accepting new patients
Southwest Center for Gastroenterology Specialist Past Accepting new patients

Locations

4007 W 63rd St
Chicago, IL 60629
Phone (773) 767-2266

3815 Highland Ave
Downers Grove, IL 60515
Phone (630) 275-5900

1300 Copperfield Ave
Ste 4050
Joliet, IL 60432
Phone (815) 723-9278

3 N Main St
Manteno, IL 60950
Phone (833) 368-8688

678 Cedar Crossings Dr
New Lenox, IL 60451
Phone (708) 499-5678

9921 Southwest Hwy
Oak Lawn, IL 60453
Phone (708) 425-2552

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233014400000",
    "number": "1144229949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9921 SOUTHWEST HWY",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533767",
            "telephone_number": "708-499-5678",
            "fax_number": "708-499-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9921 SOUTHWEST HWY",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533767",
            "telephone_number": "708-499-5678",
            "fax_number": "708-499-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DOUGLAS",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2009-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-087086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE, RRM",
            "identifier": "100012000",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL",
            "identifier": "1622260",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.