Kwang Nam Lee MD

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

036054524 Issued in IL

Legal business name

KWANG NAM LEE MD

Practice address

8340 Callie Ave
Morton Grove, IL 60053-3706

Phone

(773) 334-6311

NPI assigned

Dec 20, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Kwang Nam Lee

Title

President

Phone

(773) 874-6608

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1689943771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8340 CALLIE AVE",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600533706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8340 CALLIE AVE",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600533706",
            "telephone_number": "773-334-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWANG NAM LEE MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KWANG",
        "authorized_official_middle_name": "NAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-874-6608",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "036054524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Kornblatt, MD
• Ami Kurani Kothari, M.D.
• Andrea Kramer, MD
• Minsook DO Kroon, D.C.
• Radoslaw Tomasz Kubala
• Krista Lafferty, MS CF-SLP
• Rose Landau, BCBA
• Mary Ann Lauer
• Daniel S Lazar, M.D.
• Daniel Le

• Clinic/Center in Morton Grove, IL
• Providers in Morton Grove, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.