Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 036087952 | IL |
N | 207XS0106X | Orthopaedic Hand Surgeon | 036087952 | IL |
NPI | 1083661995 |
---|---|
Provider Name | Frank S Lee |
First Address | Mattoon, IL 61938-4653 |
Second Address | Effingham, IL 62401-1638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 26/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036087952 | (05) | IL |
389793 | HEALTHLINK (01) | IL |