Provider Demographics
NPI:1710039995
Name:LEE, BRENDAN DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:DANIEL
Last Name:LEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2004
Mailing Address - Country:US
Mailing Address - Phone:847-204-0864
Mailing Address - Fax:
Practice Address - Street 1:2909 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2004
Practice Address - Country:US
Practice Address - Phone:847-204-0864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.010823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor