Individual
JACOB STEVEN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2233 GREEN BAY RD, NORTH CHICAGO, IL 60064-3006
(847) 689-2900
Mailing address
2233 GREEN BAY RD, NORTH CHICAGO, IL 60064-3006
(847) 689-2900
(847) 689-9388
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030478
IL
122300000X
Dentist
IN PROCESS
IN
Other
Enumeration date
05/06/2015
Last updated
11/23/2018
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