Organization
JACOB S LEWIS, DMD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB STEVEN LEWIS DMD (DENTIST)
(312) 206-9541
Entity
Organization
Contact information
Practice address
2233 GREENBAY RD, NORTH CHICAGO, IL 60064
(312) 206-9541
Mailing address
829 W WAVELAND AVE, 3S, CHICAGO, IL 60613-4331
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030478
IL
Other
Enumeration date
12/20/2016
Last updated
12/20/2016
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