Active NPI
Abby Lee, DMD, MS
- Dentist
- Evergreen Park, IL
National Provider Identifier
1245805019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019033292
- Practice address
- 2835 W 95TH St
Evergreen Park, IL 60805-2702 - Phone
- (630) 962-7700
- NPI assigned
- May 24, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019033292 | IL | Primary |
Addresses
Primary practice location
2835 W 95TH St
Evergreen Park, IL 60805-2702
Mailing address
717 S Clark St Unit 2009
Chicago, IL 60605-1815
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019033292 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628294400000",
"number": "1245805019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 S CLARK ST UNIT 2009",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606051815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2835 W 95TH ST",
"city": "EVERGREEN PARK",
"state": "IL",
"postal_code": "608052702",
"telephone_number": "630-962-7700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "ABBY",
"name_prefix": "Dr.",
"credential": "DMD, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-24",
"last_updated": "2021-08-07",
"certification_date": "2021-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019033292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evergreen Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.