Individual
DR. JACOB I LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
680 N LAKE SHORE DR STE 1000, CHICAGO, IL 60611-8709
(312) 926-4723
Mailing address
465 N PARK DR, APT 2103, CHICAGO, IL 60611-0008
(931) 703-0303
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036.148258
IL
2085R0202X
Diagnostic Radiology Physician
ME124913
FL
Other
Enumeration date
05/06/2014
Last updated
07/01/2019
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