NPIMap

Individual provider Active NPI

Ha Jeong Lee, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Elk Grove Village, IL
National Provider Identifier
1881624377
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
036112455 Issued in IL
Practice address
800 Biesterfield Road
Suite 605
Elk Grove Village, IL 60007-3397
Phone
(847) 364-6724
Fax
(847) 364-6720
NPI assigned
Jul 3, 2006
Last updated
Apr 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036112455 IL Primary

Addresses

Primary practice location

800 Biesterfield Road
Suite 605
Elk Grove Village, IL 60007-3397

Mailing address

800 Biesterfield Rd Ste 605
Elk Grove Village, IL 60007-3362
Phone (847) 364-6724

Other identifiers 1

IdentifierTypeStateIssuer
036112455MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ha.lee.1@380.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060824000390 IL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 6305849746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bonaventure Medical Foundation LLCGroup PAC ID 7517863178, 164 clinicians

Practice addresses (Care Compare)

1786 Moon Lake Blvd
Hoffman Est, IL 60194-5029
Phone (847) 755-8208

800 Biesterfield Rd
Elk Grove Village, IL 60007-3362

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bonaventure Medical Foundation, LLC CurrentSince Jan 1, 2008 Accepting new patients
Alexian Brothers Medical Center Past Accepting new patients

Locations

800 Biesterfield Rd
Ste 605
Elk Grove Vlg, IL 60007
Phone (847) 364-6724

1786 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (847) 640-5640

190 W Irving Park Rd
Wood Dale, IL 60191
Phone (630) 766-0412

Interoperability endpoints

  • Direct secure messaging: ha.lee.1@380.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1881624377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD STE 605",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073362",
            "telephone_number": "847-364-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD ROAD",
            "address_2": "SUITE 605",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073397",
            "telephone_number": "847-364-6724",
            "fax_number": "847-364-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "HA",
        "middle_name": "JEONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036112455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112455",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ha.lee.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "800 Biesterfield Road",
            "address_2": "Suite 605",
            "city": "Elk Grove Village",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600073397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.