DR. SIMON LEE (NPI# 1922087691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922087691 |
| Entity Type | Individual |
| Full Name | DR. SIMON LEE |
| Credential | M.D. |
| Practice Address |
1611 W Harrison St Ste 400 Chicago IL 60612-3841 |
| Mailing Address |
1 Westbrook Corporate Ctr #240 Westchester IL 60154-5701 |
| Practice Telephone | 3122434244 |
| Practice Fax Number | 3129421517 |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2018-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
036102174 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RR MEDICARE PTAN NUMBER | DA4902 | 01 |
| AETNA | 7737378 | 01 | |
| IL | BCBS ILLINOIS | 1633878 | 01 |
| IL | MEDICARE LOCALITY #16 | 207067 | 01 |
| IL | MEDICARE LOCALITY #15 | 207073 | 01 |
| IL | RR MEDICARE PROVIDER NUMBER | P00063106 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033434113 | Simon Lee | Massage Therapist | 6500 Arlington Blvd, #206, Falls Church, VA 22042 | 2010-04-01 |
| 1104152560 | Simon Yoon Lee | Acupuncturist | 14136 Haynes St, Van Nuys, CA 91401 | 2009-10-20 |
| 1285708065 | Simon Kyejoo Lee | Chiropractor | 730 E El Camino Real, Suite B, Sunnyvale, CA 94087-2970 | 2006-11-20 |
| 1679589667 | Simon X Lee | Physical Medicine & Rehabilitation | 903 60th St Fl 1, Brooklyn, NY 11219 | 2006-07-31 |
| 1275532145 | Simon Kwanmin Lee | Internal Medicine | 1828 El Camino Real, Suite 406, Burlingame, CA 94010-3103 | 2005-07-21 |
| 1477933497 | Simon Lee | Orthopaedic Surgery | 1500 E Medical Center Dr, Tc 2912, Spc 5328, Ann Arbor, MI 48109-5000 | 2015-06-04 |
| 1639466956 | Simon Lee | Pediatrics | 700 Childrens Dr, Columbus, OH 43205 | 2011-07-07 |
| 1568621241 | Simon Lee | Acupuncturist | 5115 N Ravenswood Ave, Chicago, IL 60640-2712 | 2008-06-06 |
| 1841475662 | Simon K Lee | Pharmacist | 6605 Bay Pkwy, Brooklyn, NY 11204-3934 | 2007-12-31 |
| 1548468143 | Simon Hyun Lee | Dentist | 15130 Lakeshore Dr, Clearlake, CA 95422-8106 | 2007-07-05 |
| Street Address |
1611 W HARRISON ST STE 400 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-3841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235138546 | Thomas J Nielsen | Otolaryngology | 1611 W Harrison St, Suite 550, Chicago, IL 60612-4861 | 2005-07-19 |
| 1699376996 | Lauren Kennerly | Registered Nurse | 1611 W Harrison St, Chicago, IL 60612-4861 | 2020-11-03 |
| 1225677404 | Mary Kathleen Walsh | Orthopaedic Surgery | 1611 W Harrison St, Chicago, IL 60612-4861 | 2020-01-05 |
| 1407417900 | Megan Merritt | Specialist/Technologist | 1611 W Harrison St, Chicago, IL 60612-4861 | 2019-06-25 |
| 1881253292 | Ellen Rohan | Physician Assistant | 1611 W Harrison St, Chicago, IL 60612-4861 | 2019-06-10 |
| 1588136154 | Elle Steele | Physician Assistant | 1611 W Harrison St, Chicago, IL 60612-4861 | 2018-12-20 |
| 1720591704 | Tricia Jacobs | Speech-Language Pathologist | 1611 W Harrison St, Chicago, IL 60612-4861 | 2017-11-13 |
| 1811415227 | Emily Marie Krogel | Nurse Practitioner | 1611 W Harrison St, Chicago, IL 60612-4861 | 2017-09-06 |
| 1104376912 | Paige Maher | Physician Assistant | 1611 W Harrison St, Ste 300, Chicago, IL 60612-4861 | 2016-10-05 |
| 1902350929 | Leah Kathleen Sparker | Specialist/Technologist | 1611 W Harrison St, Orthopedic Building Suite 530, Chicago, IL 60612-4861 | 2016-08-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 207XX0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Foot and Ankle Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult reconstructive foot and ankle surgery, adult foot and ankle trauma, sports medicine foot and ankle, and children's foot and ankle reconstructive surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: title modified, definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. ACGME Accredited Residency Program Requirements: 1 year of training with 5 years Orthopedic Surgery for a total of 6 years. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275829954 | Raymond R Montoya II | Orthopaedic Surgery | 259 E Erie St Ste 2230, Chicago, IL 60611-3370 | 2011-06-21 |
| 1427505197 | Kelly Hynes | Orthopaedic Surgery | 5841 S Maryland Ave, Mc3079, Room P211m, Chicago, IL 60637-1447 | 2016-09-09 |
| 1417339995 | Kurt Krautmann | Orthopaedic Surgery | 251 E Huron St, Chicago, IL 60611-2908 | 2015-06-22 |
| 1972919702 | Jonathan L Hook | Orthopaedic Surgery | 2850 S Wabash Ave Ste 100, Chicago, IL 60616 | 2014-07-01 |
| 1770717670 | Kamran Syed Hamid | Orthopaedic Surgery | 1611 W. Harrison St, Ste 400, Chicago, IL 60612-2530 | 2009-05-06 |
| 1447206677 | Johnny L. Lin | Orthopaedic Surgery | 1611 W Harrison St # 400, Chicago, IL 60612-4861 | 2006-05-26 |
| 1568441327 | George B. Holmes | Orthopaedic Surgery | 1611 W. Harrison, Suite 400, Chicago, IL 60612 | 2006-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588189419 | Oa Associates LLC | Orthopaedic Surgery | 200 Admiral Trost Rd, Columbia, IL 62236-2163 | 2017-08-11 |
| 1497231518 | Saluja Kaushali Mahabamunuge | Orthopaedic Surgery | 2160 S 1st Ave, Maywood, IL 60153 | 2018-07-11 |
| 1528563483 | Christopher Cklamovski | Orthopaedic Surgery | 2160 S 1st Ave, Maywood, IL 60153 | 2018-03-24 |
| 1659716751 | Gina Rose Cahill | Orthopaedic Surgery | 929 W Higgins Rd, Schaumburg, IL 60195-3203 | 2013-05-02 |
| 1801181920 | Shaun Kink | Orthopaedic Surgery | 1111 Trinity Ln Ste 111, Bloomington, IL 61704-8112 | 2011-06-16 |
| 1841501962 | Bryant Shane Ho | Orthopaedic Surgery | 550 W Ogden Ave, Hinsdale, IL 60521-3186 | 2010-06-23 |
| 1194861286 | Medicall Physicians Group, Ltd. | Orthopaedic Surgery | 2040 E Algonquin Rd, Ste. 504, Schaumburg, IL 60173-4187 | 2007-01-29 |
| 1780748319 | John D Mazzarella | Orthopaedic Surgery | 3033 Ogden Ave, Ste 110, Lisle, IL 60532-1976 | 2006-12-20 |
| 1861402984 | Brian Christopher Toolan | Orthopaedic Surgery | 1206 E 9th St, Lockport, IL 60441-2404 | 2006-08-09 |
| 1154350353 | Parkview Orthopaedic Group S C | Orthopaedic Surgery | 7600 W College Dr, Palos Heights, IL 60463-1001 | 2006-07-01 |
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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.