Provider Demographics
NPI:1467520056
Name:LEE, DIANA KAR YIU (DDS)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:KAR YIU
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:FINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:565 S HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-3762
Mailing Address - Country:US
Mailing Address - Phone:630-290-6310
Mailing Address - Fax:
Practice Address - Street 1:565 S HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-3762
Practice Address - Country:US
Practice Address - Phone:630-290-6310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019024289122300000X
IL021.0018431223P0221X
IL0210018431223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist