Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Soo Mi Lee - Samuel, MD

Individual provider Child & Adolescent Psychiatry Physician · NPI 1275683211

Soo Mi Lee - Samuel, MD is a Psychiatry in Crystal Lake, Illinois. Graduated from University of Cincinnati College of Medicine in 1998, 28 years ago. Practices with Endeavor Health Medical Group, a 3,348-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
28
Trained at
University of Cincinnati College of Medicine
Licensed in
IL
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

390 E Congress Pkwy Ste J
Crystal Lake, IL 60014-6202
Phone: (815) 356-5050
Fax: (815) 356-5094
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Child & Adolescent Psychiatry Physician (primary) Taxonomy 2084P0804X · Licence 036-109024 (IL)

Record details

NPI number1275683211
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 11, 2007
Last updated in NPPESAugust 24, 2010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolUNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduated 1998 (28 years in practice)
Group practice Endeavor Health Medical Group — 3348 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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