Provider Demographics
NPI:1275868549
Name:LEE, YU-HSUAN (OT)
Entity Type:Individual
Prefix:
First Name:YU-HSUAN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 W ROOSEVLT RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1200
Mailing Address - Country:US
Mailing Address - Phone:650-427-0394
Mailing Address - Fax:312-997-3663
Practice Address - Street 1:1850 W ROOSEVLT RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1200
Practice Address - Country:US
Practice Address - Phone:650-427-0394
Practice Address - Fax:312-997-3663
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056008742225XL0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow Vision