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

Active since January 11, 2007PECOS EnrolledAccepts Medicare Assignment
390 E CONGRESS PKWY, SUITE J, CRYSTAL LAKE, IL 60014(815) 356-5050(815) 356-5094 Get Directions Write a Review

NPPES record last updated: August 24, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Soo Mi Lee - Samuel Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOO MI LEE - SAMUEL MD (NPI 1275683211) is an individual child & adolescent psychiatry provider in Crystal Lake, Illinois, licensed in Illinois (036-109024) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS, is affiliated with Northshore University Healthsystem - Evanston Hospital, and is a graduate of University Of Cincinnati College Of Medicine (1998).

NPPES Registry Identity

NPI1275683211
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameSOO MI LEE - SAMUELCredential: MD
Location Address390 E CONGRESS PKWY, SUITE JCrystal Lake, IL 60014-6202
Mailing Address1701 E. Woodfield Road, Suite 1000Schaumburg, IL 60173-5113 · (847) 240-2211 · Fax (847) 240-2418
Phone(815) 356-5050
Fax(815) 356-5094
Sole ProprietorNo
Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 1998
Enumeration DateJanuary 11, 2007
Last NPPES UpdateAugust 24, 2010
✔ NPI 1275683211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in IL · 036-109024
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.
390 E CONGRESS PKWY, Crystal Lake, IL 60014
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Other Names 1

Former Name (1)Dr. Soo Mi Lee Md

Other Identifiers 3

Medicare PIN207844IL
Other32-0084889IL · Group Tax Id Number
Other1633897IL · Group Bcbs Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Soo Mi Lee - Samuel Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567499841
PECOS Enrollment IDI20240621000456
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
21 services21 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
18 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northshore University Healthsystem - Evanston Hospital

Acute Care Hospitals · Evanston, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140010
Location2650 Ridge AveEvanston, IL 60201 · Cook County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOVEREIGN REHABILITATION OF ILLINOIS, LLC
Clinic/Center (Physical Therapy)
390 E CONGRESS PKWY
CRYSTAL LAKE, IL 60014
McHenry County (773) 755-7566
GABRIELA GONZALEZ
Behavior Technician
390 E CONGRESS PKWY
CRYSTAL LAKE, IL 60014
McHenry County (779) 284-0347
DAVID WELCH LCPC
Counselor (Professional)
390 E CONGRESS PKWY, SUITE J
CRYSTAL LAKE, IL 60014
McHenry County (815) 356-5050
TIFFANY CUBBISON
Health and Wellness Coach
390 E CONGRESS PKWY
CRYSTAL LAKE, IL 60014
McHenry County (815) 322-9300
DR. KATHRYN SCHOENBROD M.D.
Psychiatry & Neurology (Psychiatry)
390 E CONGRESS PKWY, SUITE J
CRYSTAL LAKE, IL 60014
McHenry County (815) 356-5050
MRS. PAULA FRANCES FICK OTR/L
Occupational Therapist
390 E CONGRESS PKWY, SUITE A
CRYSTAL LAKE, IL 60014
McHenry County (815) 477-4788
NANETTE LASCO MSW, LCSW
Social Worker (Clinical)
390 E CONGRESS PKWY, SUITE J
CRYSTAL LAKE, IL 60014
McHenry County (815) 356-5050
AMANDA ELIZABETH GARBIS
Behavior Technician
390 E CONGRESS PKWY
CRYSTAL LAKE, IL 60014
McHenry County (779) 284-0347

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Soo Lee - Samuel's NPI number?

The NPI number for Soo Lee - Samuel is 1275683211. It was assigned to this individual provider in the NPPES registry on January 11, 2007. The provider is also known as Dr. Soo Mi Lee MD.

Where is Soo Lee - Samuel located?

Soo Lee - Samuel practices at 390 E Congress Pkwy Suite J, Crystal Lake, IL 60014. The listed phone number is (815) 356-5050.

What is Soo Lee - Samuel's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Soo Lee - Samuel enrolled in Medicare?

Yes. Soo Lee - Samuel is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Soo Lee - Samuel accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health and UnitedHealthcare list Soo Lee - Samuel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Soo Lee - Samuel affiliated with any hospitals?

According to CMS data, Soo Lee - Samuel is affiliated with Northshore University Healthsystem - Evanston Hospital.

When was this NPI record last updated?

The NPPES record for Soo Lee - Samuel was last updated on August 24, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.