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1306467352
CODY SHANE LEE
CHICAGO, IL
NPI
1306467352
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207X00000X Orthopaedic Surgery
(Licence: IL 125076918)
Enumeration Date
2020-04-30
Last Update Date
2020-06-28
Business Address
CODY SHANE LEE
5841 S MARYLAND AVE # MC3079
CHICAGO, IL 60637-1443
Phone number: 773-834-3531
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Mailing Address
CODY SHANE LEE
180 HARVESTER DR. STE 100
BURR RIDGE, IL 60527-6686
Phone number:
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