Individual provider Active NPI

Jessica Namkyong Lee, M.D.

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1306259791
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036159956 Issued in IL
Practice address
1460 N Halsted St Ste 402
Chicago, IL 60642
Phone
(856) 237-3114
NPI assigned
Jun 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD461215 PA
Pediatrics Physician 208000000X 25MA10118600 NJ
Pediatric Gastroenterology Physician 2080P0206X MD61052083 WA
Pediatrics Physician 208000000X 036159956 IL Primary

Addresses

Primary practice location

1460 N Halsted St Ste 402
Chicago, IL 60642

Mailing address

1532 W Oakdale Ave FL 2
Chicago, IL 60657-4011
Phone (856) 237-3114

Other practice location 1

4800 Sand Point Way NE
Seattle, WA 98105-3901
Phone (206) 987-3174

Other practice location 2

2006 Salem Rd
Burlington, NJ 08016-2204
Phone (609) 877-1500

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036159956ILMDPediatrics Physician
25MA10118600NJMDPediatrics Physician
MD461215PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ann & Robert H. Lurie Children'S Hospital of Chicago Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jlee261478@direct.luriechildrens.org

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1306259791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 W OAKDALE AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574011",
            "telephone_number": "856-237-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 N HALSTED ST STE 402",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60642",
            "telephone_number": "856-237-3114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Sand Point Way NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981053901",
            "country_code": "US",
            "telephone_number": "206-987-3174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2006 Salem Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "NJ",
            "postal_code": "080162204",
            "country_code": "US",
            "telephone_number": "609-877-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JESSICA",
        "middle_name": "NAMKYONG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-04",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD461215",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA10118600",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "WA",
            "license": "MD61052083",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036159956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.