Active NPI
Steven Joo Lee, M.D.
- Family Medicine Physician
- Park Ridge, IL
National Provider Identifier
1700042041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036.121174
- Practice address
- 1400 Renaissance Dr Ste 216
Park Ridge, IL 60068-1335 - Phone
- (224) 938-9264
- Fax
- (224) 938-9266
- NPI assigned
- Aug 6, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036.121174 | IL | Primary |
Addresses
Primary practice location
1400 Renaissance Dr Ste 216
Park Ridge, IL 60068-1335
Mailing address
801 S Wells St Apt 402
Chicago, IL 60607-4581
Phone (312) 450-7166
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.121174 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healing Hands Physicians, Inc. | Past | Accepting new patients |
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.
-
- Home Health Agency
- Park Ridge, IL
- NPI 1275842502
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350000000000",
"number": "1700042041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 S WELLS ST APT 402",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606074581",
"telephone_number": "312-450-7166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 RENAISSANCE DR STE 216",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681335",
"telephone_number": "224-938-9264",
"fax_number": "224-938-9266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "STEVEN",
"middle_name": "JOO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-06",
"last_updated": "2012-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036.121174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.