Provider Demographics
NPI:1023175023
Name:LEE, JUNE (MD)
Entity type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 W NORTH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-1134
Mailing Address - Country:US
Mailing Address - Phone:708-244-7326
Mailing Address - Fax:847-537-4866
Practice Address - Street 1:665 W NORTH AVE STE 101
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-1134
Practice Address - Country:US
Practice Address - Phone:708-244-7326
Practice Address - Fax:708-393-4099
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36106856207L00000X
IL036106856207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL131983700OtherUS DEPT OF LABOR WC
IL050090672OtherRAILROAD MEDICARE
IL0161919966OtherBLUE SHIELD
IL036106856 1Medicaid
IL036106856 1Medicaid
ILL93888Medicare ID - Type Unspecified