NPIMap

Individual provider Active NPI

Young Jun Lee, MD

  • Family Medicine Physician
  • Watseka, IL
National Provider Identifier
1982281978
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036168023 Issued in IL
Practice address
806 E Walnut St
Watseka, IL 60970-1583
Phone
(815) 432-1078
Fax
(815) 432-1079
NPI assigned
Mar 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 036168023 IL Primary

Addresses

Primary practice location

806 E Walnut St
Watseka, IL 60970-1583

Mailing address

1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-4251

Other practice location 1

2750 W North Ave
Chicago, IL 60647-5247
Phone (312) 666-3494

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
I20240619002050 IL Practitioner - Family Practice 6507267887 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gibson Community Hospital AssociationGroup PAC ID 5092703124, 159 clinicians

Practice addresses (Care Compare)

806 E Walnut St
Suite a
Watseka, IL 60970-1584
Phone (815) 432-1078

Hospital & facility affiliations

  • Uplifted Care Hospice, Bourbonnais, IL, CCN 141556
  • Iroquois Memorial Hospice Hospice, Watseka, IL, CCN 141616
  • Iroquois Memorial Hospital Hospital, Watseka, IL, CCN 141353
  • Gibson Community Hospital Hospital, Gibson City, IL, CCN 141317
  • Prairieview Lutheran Home Nursing home, Danforth, IL, CCN 145953

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036168023ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association CurrentSince May 20, 2024 Accepting new patients
Gibson Community Hospital Association CurrentSince May 20, 2024 Accepting new patients
Gibson Community Hospital Association Current Accepting new patients
Gibson Community Hospital Association Current Accepting new patients
Gibson Community Hospital Association Family Medicine Past Accepting new patients

Locations

7 Doctors Park
Gibson City, IL 60936
Phone (217) 784-5500

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

806 E Walnut St
Watseka, IL 60970
Phone (815) 432-1078

806 E Walnut St
Ste A
Watseka, IL 60970
Phone (815) 432-1078

Interoperability endpoints

  • Direct secure messaging: youngjun.lee.p44@direct.gapho.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1982281978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 N MELVIN ST",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609361477",
            "telephone_number": "217-784-4251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 E WALNUT ST",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701583",
            "telephone_number": "815-432-1078",
            "fax_number": "815-432-1079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2750 W North Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606475247",
            "country_code": "US",
            "telephone_number": "312-666-3494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "YOUNG JUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036168023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watseka, IL

Sources for this page

Verify at the official NPI Registry.