Individual
LETASHA LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, FNP-C
Contact information
Practice address
20280 GOVERNORS HWY STE 102, OLYMPIA FIELDS, IL 60461-1068
(773) 234-0388
(773) 234-0394
Mailing address
900 OGDEN AVE # 335, DOWNERS GROVE, IL 60515-2829
(773) 234-0388
(773) 234-0394
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
277001315
IL
261QP3300X
Pain Clinic/Center
277001315
IL
363L00000X
Nurse Practitioner
209009526
IL
363L00000X
Nurse Practitioner
277001315
IL
363LF0000X
Family Nurse Practitioner
16661
TN
363LF0000X
Family Nurse Practitioner
Primary
277001315
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277001315
—
IL
Enumeration date
04/16/2012
Last updated
04/21/2026
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