Most Relevant Information
Provider Data
| NPI Number: | 1003578659 |
| Provider Name: | BRIAN LEE |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/12/2021 |
| Last Updated: | 10/12/2021 |
Provider Practice Location
240 E HURON ST STE 1-200
CHICAGO
IL
606112909
Practice Location Phone/Fax
| Phone: | 3125037975 |
| Fax: |
Provider Mailing Location
240 E HURON ST STE 1-200
CHICAGO
IL
606112909
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |