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Individual

TAMIKA NICOLE LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
20013 LAKEWOOD AVE, LYNWOOD, IL 60411-1515
(708) 965-2278
Mailing address
16300 WAUSAU AVE, SOUTH HOLLAND, IL 60473-2158
(708) 777-9311

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003876
IL

Other

Enumeration date
02/14/2019
Last updated
10/12/2020
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