Provider Demographics
NPI:1942378047
Name:SACKS, LEE BERNARD (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:BERNARD
Last Name:SACKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1586
Mailing Address - Country:US
Mailing Address - Phone:630-999-0510
Mailing Address - Fax:630-990-4788
Practice Address - Street 1:2025 WINDSOR DR
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1586
Practice Address - Country:US
Practice Address - Phone:630-999-0510
Practice Address - Fax:630-990-4788
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine