SOO MI LEE - SAMUEL MD
NPI 1275683211
Psychiatry & Neurology - Child & Adolescent Psychiatry in Crystal Lake, IL

NPI Status: Active since January 11, 2007

Contact Information

390 E CONGRESS PKWY
SUITE J
CRYSTAL LAKE, IL
ZIP 60014
Phone: (815) 356-5050
Fax: (815) 356-5094

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  • Individual
  • Female
  • Years of Experience 29
  • Psychiatry & Neurology
  • Child & Adolescent Psychiatry
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About SOO LEE - SAMUEL

This page provides the complete NPI Profile along with additional information for Soo Lee - Samuel, a provider established in Crystal Lake, Illinois with a medical specialization in Psychiatry & Neurology, focusing in child & adolescent psychiatry and more than 29 years of experience. She graduated from University Of Cincinnati College Of Medicine in 1998. The healthcare provider is registered in the NPI registry with number 1275683211 assigned on January 2007. The practitioner's primary taxonomy code is 2084P0804X with license number 036-109024 (IL). The provider is registered as an individual and her NPI record was last updated 16 years ago.

NPI
1275683211
Provider Name
SOO MI LEE - SAMUEL MD
Other Name
DR. SOO MI LEE MD
Other Name Type
Former Name (1)
Gender
Female
Entity Type
Individual
Location Address
390 E CONGRESS PKWY SUITE J CRYSTAL LAKE, IL 60014
Location Phone
(815) 356-5050
Location Fax
(815) 356-5094
Mailing Address
1701 E. WOODFIELD ROAD SUITE 1000 SCHAUMBURG, IL 60173
Mailing Phone
(847) 240-2211
Mailing Fax
(815) 356-5094
Medical School Name
UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduation Year
1998
Is Sole Proprietor?
No
Enumeration Date
01-11-2007
Last Update Date
08-24-2010
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychiatry & Neurology Child & Adolescent Psychiatry

Taxonomy Code
2084P0804X
Type
Allopathic & Osteopathic Physicians
License No.
036-109024
License State
IL
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
207844MEDICARE PIN (08)IL 
32-0084889OTHER (01)ILGROUP TAX ID NUMBER
1633897OTHER (01)ILGROUP BCBS NUMBER

Medicare Participation & PECOS Enrollment Status

Soo Lee - Samuel is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Soo Lee - Samuel is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 2567499841

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20240621000456

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Soo Lee - Samuel is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
NORTHSHORE UNIVERSITY HEALTHSYSTEM - EVANSTON HOSPITAL2650 RIDGE AVE
EVANSTON, IL 60201
(847) 432-8000Acute Care Hospitals

Reviews for SOO MI LEE - SAMUEL MD

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1275683211, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
5
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
8
Unchanged
Pos 7
3
Doubled → 6
Pos 8
2
Unchanged
Pos 9
1
Doubled → 2
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 6 → 12 → 3 3 → 6 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 4 + 5 + 1 + 2 + 8 + 6 + 2 + 2 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1275683211.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Counselor (Professional)
390 E CONGRESS PKWY, SUITE J
CRYSTAL LAKE, IL 60014
Social Worker
390 E CONGRESS PKWY, SUITE J
CRYSTAL LAKE, IL 60014
Social Worker (Clinical)
390 E CONGRESS PKWY, SUITE J
CRYSTAL LAKE, IL 60014
Psychologist (Clinical)
390 E CONGRESS PKWY, SUITE J
CRYSTAL LAKE, IL 60014
Counselor (Professional)
390 E CONGRESS PKWY, SUITE J
CRYSTAL LAKE, IL 60014
Otolaryngology
390 E CONGRESS PKWY, UNIT M
CRYSTAL LAKE, IL 60014
Durable Medical Equipment & Medical Supplies
390 E CONGRESS PKWY, STE M
CRYSTAL LAKE, IL 60014
Counselor (Professional)
390 E CONGRESS PKWY, SUITE J
CRYSTAL LAKE, IL 60014
Psychiatry & Neurology (Psychiatry)
390 E CONGRESS PKWY, SUITE J
CRYSTAL LAKE, IL 60014
Clinic/Center (Physical Therapy)
390 E CONGRESS PKWY
CRYSTAL LAKE, IL 60014
Clinic/Center (Primary Care)
390 E CONGRESS PKWY, SUITE H
CRYSTAL LAKE, IL 60014
Speech-Language Pathologist
390 E CONGRESS PKWY, UNIT A
CRYSTAL LAKE, IL 60014
Occupational Therapist
390 E CONGRESS PKWY, SUITE A
CRYSTAL LAKE, IL 60014
Psychiatry & Neurology (Child & Adolescent Psychiatry)
390 E CONGRESS PKWY, SUITE J
CRYSTAL LAKE, IL 60014
Speech-Language Pathologist
390 E CONGRESS PKWY, SUITE A
CRYSTAL LAKE, IL 60014
Counselor (Professional)
390 E CONGRESS PKWY, SUITE J
CRYSTAL LAKE, IL 60014
Occupational Therapy Assistant
390 E CONGRESS PKWY
CRYSTAL LAKE, IL 60014
Chiropractor
390 E CONGRESS PKWY, SUITE F
CRYSTAL LAKE, IL 60014
Occupational Therapy Assistant
390 E CONGRESS PKWY
CRYSTAL LAKE, IL 60014
Nurse Practitioner
390 E CONGRESS PKWY, SUITE C
CRYSTAL LAKE, IL 60014

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1275683211, enumerated as an "individual" on January 11, 2007.

The provider is located at 390 E CONGRESS PKWY SUITE J CRYSTAL LAKE, IL 60014 and the phone number is (815) 356-5050.

Psychiatry & Neurology with taxonomy code 2084P0804X and a focus in Child & Adolescent Psychiatry.

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter Health,. Please consult your insurance carrier or call the provider to verify.

Soo Lee - Samuel is affiliated with: NORTHSHORE UNIVERSITY HEALTHSYSTEM - EVANSTON HOSPITAL.