Individual provider Active NPI

Sung Ah Lee, D.O.

  • Internal Medicine Physician
  • Hinsdale, IL
National Provider Identifier
1497773717
Registry record updated Mar 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036118466 Issued in IL
Practice address
15 Salt Creek LN
Suite 111
Hinsdale, IL 60521-2926
Phone
(630) 371-0133
Fax
(630) 371-0138
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A9259 CA
Internal Medicine Physician 207R00000X 036118466 IL Primary

Addresses

Primary practice location

15 Salt Creek LN
Suite 111
Hinsdale, IL 60521-2926

Mailing address

435 W Wood St
#302
Palatine, IL 60067-7813
Phone (847) 682-5920

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
20A9259CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235952000000",
    "number": "1497773717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 W WOOD ST",
            "address_2": "#302",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600677813",
            "telephone_number": "847-682-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SALT CREEK LN",
            "address_2": "SUITE 111",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605212926",
            "telephone_number": "630-371-0133",
            "fax_number": "630-371-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUNG AH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2009-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A9259",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036118466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; 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.