LEE JENKINS MD SC (NPI# 1073551644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073551644 |
| Entity Type | Organization |
| Organization Name | LEE JENKINS MD SC |
| Practice Address |
675 W North Ave Suite 408 Melrose Park IL 60160 |
| Practice Telephone | 7084504950 |
| Practice Fax Number | 7083438505 |
| Mailing Telephone | 7084504950 |
| Mailing Fax Number | 7083438505 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2008-09-08 |
| NPI Deactivation Date | 08/25/2008 |
| NPI Reactivation Date | 2008-09-04 |
| Authorized Official Name | DR. LEE THOMAS JENKINS (MD PRESIDENT) |
| Authorized Official Telephone | 7084504950 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 036088632 | IL | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036088632 | 05 | |
| IL | BLUE CROSS / BLUE SHIELD | 1623294 | 01 |
| Street Address |
675 W NORTH AVE SUITE 408 |
| City | MELROSE PARK |
| State | IL |
| Zip Code | 60160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235134727 | Brad Anstadt | Ophthalmology | 675 W North Ave, Ste 107, Melrose Park, IL 60160-1622 | 2005-06-20 |
| 1578920484 | Dupage Medical Group, Ltd. | Prosthetic/Orthotic Supplier | 675 W North Ave, Melrose Park, IL 60160-1634 | 2016-01-22 |
| 1356733034 | Jessica Lynn Dye | Physician Assistant | 675 W North Ave, Suite 607, Melrose Park, IL 60160-1634 | 2015-03-04 |
| 1861893463 | Paige D Formsma | Audiologist | 675 W North Ave, Suite 110, Melrose Park, IL 60160-1634 | 2014-09-15 |
| 1083014047 | Jennifer Morales | Psychologist | 675 W North Ave, Ste 306, Melrose Park, IL 60160-1634 | 2014-08-27 |
| 1538577754 | Elizabeth Bojarskyj | Pharmacist | 675 W North Ave, Melrose Park, IL 60160-1634 | 2014-07-31 |
| 1780091538 | Bryan David Erce | Dentist | 675 W North Ave, Suite 307, Melrose Park, IL 60160-1634 | 2014-07-14 |
| 1740619246 | Merissa Mann | Physician Assistant | 675 W North Ave, Suite 402, Melrose Park, IL 60160-1634 | 2013-11-05 |
| 1770916074 | Yonatan Rosenblum | Psychologist | 675 W North Ave, Suite 306, Melrose Park, IL 60160-1634 | 2013-08-10 |
| 1538509666 | Hai Solomon M.d.s.c. | Obstetrics & Gynecology | 675 W North Ave, Suite 512, Melrose Park, IL 60160-1634 | 2013-07-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295217651 | Kairsten Thies | Registered Nurse | 1225 W. Lake St., Melrose Park, IL 60160 | 2018-09-02 |
| 1780195701 | Julia Mccann-khludenev | Nurse Practitioner | 153 1/2 Broadway Ave., Melrose Park, IL 60160 | 2017-10-17 |
| 1629595749 | Katarzyna Teresa Buksa | Speech-Language Pathologist | 906 Walton St., Melrose Park, IL 60160 | 2017-08-29 |
| 1972955102 | Erika Lazaro | Counselor | 1414 Main Street, Melrose Park, IL 60160 | 2016-07-12 |
| 1811344096 | Margaret Ann Kress | Nurse Practitioner | 675 W North Ave Ste 402, Melrose Park, IL 60160 | 2016-05-18 |
| 1942578703 | Rachna Shah Md Sc | Internal Medicine | 675 West North Ave, #310, Melrose Park, IL 60160 | 2011-12-08 |
| 1033486741 | Stephanie Lamonica | Pharmacist | 850 West North Ave, T0837, Melrose Park, IL 60160 | 2011-11-23 |
| 1285913384 | Melinda Vazquez | Social Worker | 1414 Main, Melrose Park, IL 60160 | 2011-08-08 |
| 1629373212 | Advanced Wellness Clinics | Internal Medicine | 1835 N Broadway Avenue, Suite 104, Melrose Park, IL 60160 | 2011-01-13 |
| 1508188525 | Guillermo Fernando Mora | Family Medicine | 1111 W Superior, Suite #306, Melrose Park, IL 60160 | 2010-02-17 |
| Find all providers in zip 60160 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265625610 | Raul Villasuso Mdsc | Surgery | 675 W North Ave Ste 201, Melrose Park, IL 60160-1629 | 2007-08-20 |
| 1235246208 | Sung Wun Kim | Surgery | 675 W North Ave, Suite 408, Melrose Park, IL 60160-1634 | 2006-08-24 |
| 1851318703 | Borys Sumyk, M.d., S.c. | Surgery | 1225 West Lake Street, Westlake Hospital, Melrose Park, IL 60160 | 2006-07-16 |
| 1548202575 | Lee Jenkins | Surgery | 675 W North Ave, Suite 408, Melrose Park, IL 60160-1634 | 2006-06-12 |
| 1447217625 | Raul Villasuso | Surgery | 675 W North Ave, Suite 201, Melrose Park, IL 60160-1634 | 2006-04-30 |
| 1770588287 | Michael R Dehaan | Surgery | 675 W North Ave, Suite 206, Melrose Park, IL 60160-1634 | 2005-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1376167809 | Francesco Bajani | Surgery | 664 N Dearborn St Apt 2f, Chicago, IL 60654-3848 | 2020-06-01 |
| 1972123099 | Andrea Liu | Surgery | 5841 S Maryland Ave Mc6040, Chicago, IL 60637-1443 | 2020-04-18 |
| 1750917183 | Alberto Maria Fratti | Surgery | 901 S Ashland Ave Apt 711, Chicago, IL 60607-4088 | 2020-03-17 |
| 1841845047 | Barijuve Surgical LLC | Surgery | 380 E Northwest Hwy Ste 200, Des Plaines, IL 60016-2274 | 2019-08-05 |
| 1164081782 | Sean Park | Surgery | 1739 Tudor Ln Unit 308, Northbrook, IL 60062-3778 | 2019-06-07 |
| 1376014175 | Edwardsville Physicians Group LLC | Surgery | 441 South State Route 157 Suite 102, Edwardsville, IL 62025-4012 | 2018-12-06 |
| 1316421324 | Erica Lester | Surgery | John H Stroger, 1969 Ogden Ave, Chicago, IL 60612 | 2018-09-17 |
| 1023513389 | Crystal Siyu Zhang | Surgery | 2160 S 1st Ave Bldg 3210, Maywood, IL 60153 | 2018-03-28 |
| 1376047381 | Richard Lawrence Nelson | Surgery | 1603 W. Taylor St., Room 983, Chicago, IL 60612-4394 | 2018-03-23 |
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| City | MELROSE PARK |
| Zip Code | 60160 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.