Provider Demographics
NPI:1588811830
Name:LEES, ALLISON E (RD, LDN)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:E
Last Name:LEES
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1343 W CORNELIA AVE # 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1401
Mailing Address - Country:US
Mailing Address - Phone:773-573-8169
Mailing Address - Fax:
Practice Address - Street 1:1343 W CORNELIA AVE # 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-1401
Practice Address - Country:US
Practice Address - Phone:773-573-8169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.004414133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered