Provider Demographics
NPI:1619052719
Name:JONG HO LEE CHIROPRACTIC CORP.
Entity Type:Organization
Organization Name:JONG HO LEE CHIROPRACTIC CORP.
Other - Org Name:JONG HO LEE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONGHO
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-375-8770
Mailing Address - Street 1:675 N WOLF RD
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1045
Mailing Address - Country:US
Mailing Address - Phone:847-375-8770
Mailing Address - Fax:847-298-4472
Practice Address - Street 1:675 N WOLF RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1045
Practice Address - Country:US
Practice Address - Phone:847-375-8770
Practice Address - Fax:847-298-4472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty