Provider Demographics
NPI:1700086980
Name:RHEE, LESLEY (MD)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:
Last Name:RHEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 PARK AVE W STE 2850
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2558
Mailing Address - Country:US
Mailing Address - Phone:847-765-7190
Mailing Address - Fax:847-657-1961
Practice Address - Street 1:757 PARK AVE W STE 2850
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2558
Practice Address - Country:US
Practice Address - Phone:847-765-7190
Practice Address - Fax:847-657-1961
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036121057207RG0100X
IN01071040207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201044130Medicaid
IN47715001Medicare PIN