Provider Demographics
NPI:1407062953
Name:LEE, JANET A (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:A
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-3152
Mailing Address - Country:US
Mailing Address - Phone:630-668-8250
Mailing Address - Fax:630-668-9561
Practice Address - Street 1:2015 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-3152
Practice Address - Country:US
Practice Address - Phone:630-668-8250
Practice Address - Fax:630-668-9561
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-118329207W00000X, 207WX0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036118329Medicaid
ILP00670574OtherRAILROAD MEDICARE
IL0534150004Medicare NSC
ILP00670574OtherRAILROAD MEDICARE
IL0534150002Medicare NSC
IL0534150003Medicare NSC