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Organization

JOHNNIE LEWIS D.P.M P.C

Active
Parent organization
JOHNNIE LEWIS D.P.M. P.C
Organization subpart
Yes

Provider details

NPI number
Legal business name
JOHNNIE LEWIS D.P.M. P.C
Authorized official
DR. JOHNNIE LEWIS DPM (PRESIDENT)
(312) 674-1191
Entity
Organization

Contact information

Practice address
2850 S WABASH AVE, STE 206, CHICAGO, IL 60616-2955
(312) 674-1191
(312) 674-1192
Mailing address
2850 S WABASH AVE, STE 206, CHICAGO, IL 60616-2955
(312) 674-1191
(312) 674-1192

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004605
IL

Other

Enumeration date
11/24/2008
Last updated
12/03/2011
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