Individual
VIOLET STAR LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5025 S JOHNNY RUN RD, KINSMAN, IL 60437-4022
(815) 999-1855
Mailing address
5025 S. JOHNNY RUN RD., KINSMAN, IL 60437
(815) 999-1855
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
IL
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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