Lee, Kenneth K

Lee, Kenneth K is an individual health care provider with primary practice located at 885 Roosevelt Rd , Glen Ellyn IL 60137-6141. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Lee, Kenneth K can be contacted via phone (630) 545-3760.

Contact Information

Primary practice address
885 Roosevelt Rd Glen Ellyn IL 60137-6141
Phone: (630) 545-3760
Fax: (630) 545-3769
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036100509 Illinois

Profile Details

NPI number 1043245970
LBN Legal business name Lee, Kenneth K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Apr 10th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043245970 NPPES
Illinois Other 0222075 BLUE CROSS GROUP NUMBER
Illinois Other 3631498336019001 BLUE CROSS GROUP NUMBER
Illinois Other 363149833 BLUE CROSS GROUP NUMBER
Illinois MEDICAID 036100509 BLUE CROSS GROUP NUMBER

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