Otto K Lee, MD is a medicare enrolled "Family Medicine" physician in Bridgeview, Illinois. His current practice location is
7020 W 79th St, Bridgeview, Illinois. You can reach out to his office (for appointments etc.) via phone at
(708) 599-8200.
Otto K Lee is licensed to practice in Illinois (license number 036117514) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1013108422.
Physician's Profile
Full Name | Otto K Lee |
---|
Gender | Male |
---|
Speciality | Family Medicine |
---|
Location | 7020 W 79th St, Bridgeview, Illinois |
---|
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1013108422
- Provider Enumeration Date: 08/09/2007
- Last Update Date: 06/23/2011
Medicare PECOS Information:
- PECOS PAC ID: 5799877759
- Enrollment ID: I20070822000597
Medical Identifiers
Medical identifiers for Otto K Lee such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1013108422 | NPI | - | NPPES |
0222075 | Other | IL | BLUE CROSS GROUP NUMBER |
363149833 | Other | IL | TAX IDENTIFICATION NUMBER |
3631498336019001 | Other | IL | CDPG HFS PAYEE ID |
482450 | Other | IL | MEDICARE GROUP NUMBER |
036117514 | Medicaid | IL | |
P00425248 | Other | IL | MEDICARE RAILROAD |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 036117514 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Otto K Lee is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Otto K Lee, MD 7020 W 79th St, Bridgeview, IL 60455-4030 Ph: (708) 599-8200 | Otto K Lee, MD 7020 W 79th St, Bridgeview, IL 60455-4030 Ph: (708) 599-8200 |
Reviews and Comments