Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath | 198000341 | IL |
NPI | 1043468283 |
---|---|
Provider Name | Christina Mary Lee |
First Address | Chicago, IL 60601-7810 |
Second Address | Chicago, IL 60601-7810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2008 |
Last Update Date | 29/08/2008 |