Provider Demographics
NPI:1164418802
Name:LEE, WILLIAM WAH HING (EDD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:WAH HING
Last Name:LEE
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 WARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044-1322
Mailing Address - Country:US
Mailing Address - Phone:847-623-2177
Mailing Address - Fax:847-234-3193
Practice Address - Street 1:29 WARRINGTON DR
Practice Address - Street 2:
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-1322
Practice Address - Country:US
Practice Address - Phone:847-623-2177
Practice Address - Fax:847-234-3193
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-002329103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212053Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
ILR17633Medicare UPIN