| 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 |