SOO MI LEE - SAMUEL


Address: 390 E Congress Pkwy, Suite J, Crystal Lake, IL 60014-6202
Phone: 8153565050

SOO MI LEE - SAMUEL (NPI# 1275683211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1275683211
Entity Type Individual
Full Name SOO MI LEE - SAMUEL
Other Name DR. SOO MI LEE
Credential MD
Practice Address 390 E Congress Pkwy
Suite J
Crystal Lake
IL 60014-6202
Mailing Address 1701 E. Woodfield Road
Suite 1000
Schaumburg
IL 60173-5113
Practice Telephone 8153565050
Practice Fax Number 8153565094
Mailing Telephone 8472402211
Mailing Fax Number 8472402418
Enumeration Date 2007-01-11
Last Update Date 2010-08-24
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084P0804X Psychiatry & Neurology
Specialization: Child & Adolescent Psychiatry
036-109024 IL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IL GROUP BCBS NUMBER 1633897 01

Office Location

Street Address 390 E CONGRESS PKWY
SUITE J
City CRYSTAL LAKE
State IL
Zip Code 60014-6202

Providers in the same location

NPI Name Taxonomy Address Enumeration
1790887040 Jeana Altman Counselor 390 E Congress Pkwy, Suite J, Crystal Lake, IL 60014-6202 2006-09-05
1851812507 Amy Lynn Boyce Audiologist 390 E Congress Pkwy, Crystal Lake, IL 60014 2017-07-03
1730632407 Joanna Hutson Nurse Practitioner 390 E Congress Pkwy, Suite C, Crystal Lake, IL 60014-6202 2016-07-29
1134578453 Nicole A Glinski Occupational Therapy Assistant 390 E Congress Pkwy, Crystal Lake, IL 60014-6202 2016-06-07
1447634472 Allyson D Weiss Audiologist 390 E Congress Pkwy, Crystal Lake, IL 60014-6202 2015-07-20
1497137657 Kathleen Lepage Speech-Language Pathologist 390 E Congress Pkwy, Crystal Lake, IL 60014-6202 2015-06-24
1518367911 Colleen Ann Rodgers Occupational Therapy Assistant 390 E Congress Pkwy, Crystal Lake, IL 60014-6202 2014-09-04
1225453459 Steve J Kim Counselor 390 E Congress Pkwy, Suite J, Crystal Lake, IL 60014-6202 2014-02-25
1720425465 Carissa Lynn Thiele Speech-Language Pathologist 390 E Congress Pkwy, Suite A, Crystal Lake, IL 60014-6202 2013-06-03
1104175447 Paula Frances Fick Occupational Therapist 390 E Congress Pkwy, Suite A, Crystal Lake, IL 60014-6202 2012-08-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1497394720 Lorelei Mariano Physical Therapist 350 E Congress Parkway Ste A, Crystal Lake, IL 60014 2020-01-03
1396227070 Behavioral Services for Autism, Inc Behavioral Analyst 1095 Pingree Road, Suite 204, Crystal Lake, IL 60014 2018-08-30
1831635564 Isis Mendoza-garnica Counselor 6803 Rose Ave, Crystal Lake, IL 60014 2017-01-19
1134664402 Derick Dermatology, LLC Non-Pharmacy Dispensing Site 525 E Congress Parkway, Suite 200, Crystal Lake, IL 60014 2016-12-22
1306394051 Highland Park Cvs, L.L.C. Durable Medical Equipment & Medical Supplies 177 W Virginia Street, Crystal Lake, IL 60014 2016-09-12
1124492830 Align Spine & Orthopaedics Durable Medical Equipment & Medical Supplies 60 B West Terra Cotta Ave, #265, Crystal Lake, IL 60014 2015-11-18
1558747428 Shabana Nawaz Optometrist 4777 Northwest Highway, Crystal Lake, IL 60014 2015-08-03
1548649205 Daniel Okon Social Worker 304 Charllote Ave, Crystal Lake, IL 60014 2015-05-27
1154729838 Crystal Lake Center for Chronic Pain Sc Nurse Practitioner 1 South Northwest Highway, Crystal Lake, IL 60014 2014-12-12
1558763581 Brooke Nicole Grandt Occupational Therapist 394 Heisler Ct, Crystal Lake, IL 60014 2014-09-22
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Taxonomy Information

Taxonomy Code 2084P0804X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Child & Adolescent Psychiatry

Taxonomy Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1205834017 Mohinder Chadha Psychiatry & Neurology 500 Coventry Ln, Suite 205, Crystal Lake, IL 60014-7579 2005-07-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1144851684 Greywood Health Center LLC Psychiatry & Neurology 303 W Institute Pl Fl 3, Chicago, IL 60610-3080 2020-02-03
1285273540 Tms Clinical Services Pllc Psychiatry & Neurology 1100 Jorie Blvd Ste 172, Oak Brook, IL 60523-4409 2020-01-03
1942702386 Brain and Wellness Institute LLC Psychiatry & Neurology 30 W Oak St Apt 14a, Chicago, IL 60610-8724 2018-03-01
1598278749 Elemental Treatment Center Ltd Psychiatry & Neurology 612 S Western Ave Apt 1, Chicago, IL 60612-4682 2017-11-09
1225404551 Family Renewed, LLC Psychiatry & Neurology 1004 Pebble Beach Dr, Caseyville, IL 62232-2834 2015-08-21
1487032082 Jerry Francisco Benzl Psychiatry & Neurology 1740 Taylor St., Chicago, IL 60612 2015-05-14
1942697800 Dr Mo S.c Psychiatry & Neurology 2131 W Silverleaf Ln, Addison, IL 60101-6404 2015-04-17
1104234046 Hitekshya Nepal Psychiatry & Neurology 5230 6th Street Frontage Rd E, Springfield, IL 62703-5128 2014-07-23
1740558261 Jyoti Shah Psychiatry & Neurology 1335 N Mill St Ste 100, Naperville, IL 60563-2047 2011-12-12
1083921530 Jodi Chase Psychiatry & Neurology 480 Elm Pl Ste 106, Highland Park, IL 60035-2535 2010-09-04
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Competitor

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City CRYSTAL LAKE
Zip Code 60014

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Dataset Information

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.

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