Lee Lichtenberg
Rheumatology
302 Randall Rd
Geneva
, Illinois 60134-4209
Lee Lichtenberg
Rheumatology
302 Randall Rd
Geneva
, Illinois 60134-4209
(630) 232-2472
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About
Features
Specialties
- Rheumatology
Languages spoken
- English
Location
First Address
- Lee Lichtenberg
- 302 Randall Rd
- Geneva, IL
- Zip : 60134-4209
- Fax : (630) 232-2472
- Phone : (630) 232-2391
Second Address
- Lee Lichtenberg
- 302 Randall Rd
- Geneva, IL
- Zip : 60134-4209
- Fax : (630) 232-2472
- Phone : (630) 232-2391
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RR0500X | Rheumatology | 36054148 | IL |
National Provider Identifier
| NPI | 1134106008 |
|---|---|
| Provider Name | Lee Lichtenberg |
| First Address | Geneva, IL 60134-4209 |
| Second Address | Geneva, IL 60134-4209 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/12/2005 |
| Last Update Date | 16/12/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036054148 | MEDICAID (01) | IL |
| 206147 | MEDICARE PTAN (GROUP) (01) | IL |
| 206147236 | MEDICARE PTAN (INDIVIDUAL) (01) | IL |
| 36054148 | (05) | IL |
| C44846 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.