Provider Demographics
NPI:1164566352
Name:LEE, JIHYE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JIHYE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 MILWAUKEE AVE
Mailing Address - Street 2:SUITE 185
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-7802
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:611 MILWAUKEE AVE
Practice Address - Street 2:SUITE 185
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-7802
Practice Address - Country:US
Practice Address - Phone:847-998-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2010-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-026745122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist