Individual provider Active NPI

Christine J Lee, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1336443597
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
346003151 Issued in IL
Practice address
676 N Saint Clair St
1500
Chicago, IL 60611-2927
Phone
(312) 475-1000
NPI assigned
Jan 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 346003151 IL Primary

Addresses

Primary practice location

676 N Saint Clair St
1500
Chicago, IL 60611-2927

Mailing address

2013 Milwaukee Ave
Riverwoods, IL 60015-3581
Phone (224) 676-1022

Other practice location 1

2013 Milwaukee Ave
Riverwoods, IL 60015-3581
Phone (224) 676-1022

Other identifiers 1

IdentifierTypeStateIssuer
046.010329MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111013000216 IL Practitioner - Optometry 9638341761 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
346003151ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University Eye Specialists LTD Optometrist CurrentSince Sep 29, 2011 Accepting new patients

Locations

676 N Saint Clair St
Ste 1500
Chicago, IL 60611
Phone (312) 475-1000

1535 Lake Cook Rd
Northbrook, IL 60062
Phone (847) 205-1680

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": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1336443597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 MILWAUKEE AVE",
            "city": "RIVERWOODS",
            "state": "IL",
            "postal_code": "600153581",
            "telephone_number": "224-676-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST",
            "address_2": "1500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112927",
            "telephone_number": "312-475-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2013 Milwaukee Ave",
            "address_purpose": "LOCATION",
            "city": "Riverwoods",
            "state": "IL",
            "postal_code": "600153581",
            "country_code": "US",
            "telephone_number": "224-676-1022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHRISTINE",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-03",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "346003151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046.010329",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.