Soo Mi Lee - Samuel, MD in Crystal Lake, IL

Soo Mi Lee - Samuel, MD is a medicare enrolled "Psychiatry & Neurology - Child & Adolescent Psychiatry" physician in Crystal Lake, Illinois. She went to University Of Cincinnati College Of Medicine and graduated in 1998 and has 28 years of diverse experience with area of expertise as Psychiatry. She is a member of the group practice Endeavor Health Medical Group and her current practice location is 390 E Congress Pkwy, Suite J, Crystal Lake, Illinois. You can reach out to her office (for appointments etc.) via phone at (815) 356-5050.

Soo Mi Lee - Samuel is licensed to practice in Illinois (license number 036-109024) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1275683211.

Contact Information

	Soo Mi Lee - Samuel, MD
	390 E Congress Pkwy, Suite J, Crystal Lake, IL 60014-6202
	(815) 356-5050
	(815) 356-5094

Map and Direction

Physician's Profile

Full Name	Soo Mi Lee - Samuel
Gender	Female
Speciality	Psychiatry
Experience	28 Years
Location	390 E Congress Pkwy, Crystal Lake, Illinois
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Soo Mi Lee - Samuel attended and graduated from University Of Cincinnati College Of Medicine in 1998

NPI Data:

NPI Number: 1275683211
Provider Enumeration Date: 01/11/2007
Last Update Date: 08/24/2010

Medicare PECOS Information:

PECOS PAC ID: 2567499841
Enrollment ID: I20240621000456

Medical Identifiers

Medical identifiers for Soo Mi Lee - Samuel such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1275683211	NPI	-	NPPES
1633897	Other	IL	GROUP BCBS NUMBER

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2084P0804X	Psychiatry & Neurology - Child & Adolescent Psychiatry	036-109024 (Illinois)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Northshore University Healthsystem - Evanston Hospital	Evanston, IL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Endeavor Health Medical Group	2163334699	3022

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Soo Mi Lee - Samuel allows following entities to bill medicare on her behalf.

Entity Name	Endeavor Health Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1497701882 PECOS PAC ID: 2163334699 Enrollment ID: O20040524000118

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Soo Mi Lee - Samuel is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Soo Mi Lee - Samuel, MD 1701 E. Woodfield Road, Suite 1000, Schaumburg, IL 60173-5113 Ph: (847) 240-2211	Soo Mi Lee - Samuel, MD 390 E Congress Pkwy, Suite J, Crystal Lake, IL 60014-6202 Ph: (815) 356-5050

Reviews and Comments

Psychiatry & Neurology Doctors in Crystal Lake, IL

Dr. Edwin Vera Gumapas, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 25 S Virginia St, Ste 201, Crystal Lake, IL 60014 Phone: 815-356-0475 Fax: 815-356-0796
Dr. Kathryn Schoenbrod, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 390 E Congress Pkwy, Suite J, Crystal Lake, IL 60014 Phone: 815-356-5050 Fax: 815-356-5094
Jessica Wolf, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 360 Station Dr Ste 300, Crystal Lake, IL 60014 Phone: 815-455-1800
Dr. Ramesh Babu Vemuri, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 145 S Virginia St, Crystal Lake, IL 60014 Phone: 815-444-9999 Fax: 815-397-2712
Mrs. Mohinder Chadha, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 500 Coventry Ln, Suite 205, Crystal Lake, IL 60014 Phone: 815-455-7100 Fax: 815-455-3951
Katherine Ann Godfrey, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 390 E Congress Pkwy, Suite J, Crystal Lake, IL 60014 Phone: 815-356-5050 Fax: 815-356-5094
Venkata C Jampala, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 500 Coventry Ln, Suite 205, Crystal Lake, IL 60014 Phone: 815-455-7100 Fax: 815-455-3951

Soo Mi Lee - Samuel, MD - Medicare Psychiatry in Crystal Lake, IL