Provider Demographics
NPI:1669687984
Name:FRANCIS C LEE, MD SC
Entity type:Organization
Organization Name:FRANCIS C LEE, MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:217-877-7171
Mailing Address - Street 1:606 W PERSHING RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-1633
Mailing Address - Country:US
Mailing Address - Phone:217-877-7171
Mailing Address - Fax:
Practice Address - Street 1:606 W PERSHING RD
Practice Address - Street 2:SUITE E
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-1633
Practice Address - Country:US
Practice Address - Phone:217-877-7171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036042486207ND0900X, 207NI0002X, 207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Multi-Specialty
No207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological ImmunologyGroup - Multi-Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5800184OtherBLUE CROSS BLUE SHIELD
IL036042486Medicaid
IL036042486Medicaid
IL5800184OtherBLUE CROSS BLUE SHIELD