Otto K Lee, MD | |
7020 W 79th St, Bridgeview, IL 60455-4030 | |
(708) 599-8200 | |
(708) 599-8306 |
Full Name | Otto K Lee |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 7020 W 79th St, Bridgeview, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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 |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 036117514 (Illinois) | Primary |
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 |
Mithila Janakiram, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7020 W 79th St, Bridgeview, IL 60455 Phone: 708-599-8200 |