Individual provider Active NPI

Tylor Kue Lee, MD

  • Student in an Organized Health Care Education/Training Program
  • Chicago, IL
National Provider Identifier
1831957257
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
901 S Ashland Ave Apt 402
Chicago, IL 60607-4084
Phone
(678) 576-0003
NPI assigned
Mar 11, 2024
Reactivated
May 6, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

901 S Ashland Ave Apt 402
Chicago, IL 60607-4084

Mailing address

901 S Ashland Ave Apt 402
Chicago, IL 60607-4084
Phone (678) 576-0003

Other practice location 1

1480 Wrightsboro Rd Apt 1218
Augusta, GA 30901-3206
Phone (678) 576-0003

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250624003431 IL Order and Referring Only - OtolaryngologyPractitioner - Otolaryngology 0749792828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: klee171932@uihealth.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1831957257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 S ASHLAND AVE APT 402",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074084",
            "telephone_number": "678-576-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S ASHLAND AVE APT 402",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074084",
            "telephone_number": "678-576-0003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1480 Wrightsboro Rd Apt 1218",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309013206",
            "country_code": "US",
            "telephone_number": "678-576-0003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "TYLOR",
        "middle_name": "KUE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-11",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "deactivation_date": "2025-03-24",
        "reactivation_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.