Organization
FRONTIER HEALTHCARE SYSTEMS OF ILLINOIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LETASHA LEWIS APN (OWNER)
(901) 283-4011
Entity
Organization
Contact information
Practice address
20280 GOVERNORS HWY STE 102, OLYMPIA FIELDS, IL 60461-1068
(708) 234-0388
(708) 234-0394
Mailing address
900 OGDEN AVE # 335, DOWNERS GROVE, IL 60515-2829
(708) 234-0388
(708) 234-0394
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP3300X
Pain Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277001315
—
IL
Enumeration date
03/17/2016
Last updated
04/21/2026
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