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Individual
MARY ELIZABETH LEWIS
Active
Individual
MARY ELIZABETH LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C-FNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
036066331
IL
363LF0000X
Family Nurse Practitioner
Primary
209002626
IL
363LG0600X
Gerontology Nurse Practitioner
209002626
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069915
HEALTH ALLIANCE
IL
01
—
500014413
RAILROAD MEDICARE
IL
01
—
563097
HEALTHLINK
IL
01
—
7215059
BCBS PPO
IL
01
—
IL01Q8
JOHN DEERE
IL
Enumeration date
07/31/2006
Last updated
12/04/2024
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