Individual
KHADIJAH A LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T
Contact information
Practice address
3506 WASHINGTON RD, KENOSHA, WI 53144-1654
(262) 653-3814
Mailing address
4415 W LAWN AVE, WAUKEGAN, IL 60085-8664
(773) 807-0487
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070014658
IL
225100000X
Physical Therapist
Primary
11149-24
WI
Other
Enumeration date
12/10/2011
Last updated
02/18/2026
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