Individual
DR. GREGORY N LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
071004107
IL
103TC0700X
Clinical Psychologist
Primary
071-004107
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02215643
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/20/2006
Last updated
04/26/2021
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