Active NPI
Hyoseon Lee
- Dentist
- Chicago, IL
National Provider Identifier
1588926802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.029063
- Practice address
- 3030 N Broadway St Ste 400
Chicago, IL 60657-7472 - Phone
- (773) 800-2905
- NPI assigned
- Jun 12, 2012
- Last updated
- Mar 4, 2024
- 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 | 019.029063 | IL | Primary |
Addresses
Primary practice location
3030 N Broadway St Ste 400
Chicago, IL 60657-7472
Mailing address
3030 N Broadway St Ste 400
Chicago, IL 60657-7472
Phone (773) 800-2905
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151214001753 | IL | Order and Referring Only - Dentist | 2062713126 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.029063 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HS Lee & Associates, LTD | Current | Accepting new patients |
Locations
3030 N Broadway St
Ste 400
Chicago, IL 60657
Phone (773) 800-2905
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709510400000",
"number": "1588926802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3030 N BROADWAY ST STE 400",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606577472",
"telephone_number": "773-800-2905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3030 N BROADWAY ST STE 400",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606577472",
"telephone_number": "773-800-2905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "HYOSEON",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-12",
"last_updated": "2024-03-04",
"certification_date": "2024-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.029063",
"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 Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.