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

Soo Mi Lee - Samuel, MD is a medicare enrolled "Psychiatry & Neurology - Child & Adolescent Psychiatry" physician in Crystal Lake, Illinois. 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 does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. 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 & Neurology - Child & Adolescent Psychiatry
Location	390 E Congress Pkwy, Crystal Lake, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

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

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: Accepting Medicare Assignments 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: Medicare Enrolled Practice Location: 360 Station Dr Ste 300, Crystal Lake, IL 60014 Phone: 815-455-1800
Dr. Ramesh Babu Vemuri, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments 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: May Accept 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 & Neurology in Crystal Lake, IL