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John Ken Lee

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NPI Number Detailed Information

Provider Information:

Name: John Ken Lee
Gender: M
Provider License Number If Given:

NPI Information:

NPI: 1891794475
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 2/19/2008

Provider Business Mailing Address:

Address: 8135 N MILWAUKEE AVE
Niles, IL 60714
Phone Number: 8479678098
Fax Number: 8479678594

Provider Business Practice Location Address:

Address: 450 W HIGHWAY 22
Barrington, IL 60010
Phone Number: 8473819600
Fax Number:

Provider Taxonomy:

Primary: 207L00000X
Secondary (if any):
State: IL

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