Richard H. Lee M.D., S.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036085019 Issued in IL

Legal business name

RICHARD H. LEE M.D., S.C.

Practice address

5747 W. Dempster St
Suite a
Morton Grove, IL 60053-3061

Phone

(847) 583-9999

Fax

(847) 583-0036

NPI assigned

Aug 12, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Richard H. Lee, M.D.

Title

President

Phone

(847) 583-9999

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1609022516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5747 W. DEMPSTER ST.",
            "address_2": "SUITE A",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600533061",
            "telephone_number": "847-583-9999",
            "fax_number": "847-583-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5747 W. DEMPSTER ST",
            "address_2": "SUITE A",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600533061",
            "telephone_number": "847-583-9999",
            "fax_number": "847-583-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD H. LEE M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-583-9999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036085019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085619",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/C",
            "identifier": "31604646",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; 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.