Organization
FRONTIER HEALTHCARE SYSTEMS OF ILLINOIS LLC
Active
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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