Individual
DR. JOHNATHAN PATRICK LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
520 S MAPLE AVE, OAK PARK, IL 60304-1022
(708) 660-5997
(630) 660-2251
Mailing address
520 S MAPLE AVE, OAK PARK, IL 60304-1022
(708) 660-5997
(630) 660-2251
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036163696
IL
390200000X
Student in an Organized Health Care Education/Training Program
5151014031
MI
Other
Enumeration date
06/14/2019
Last updated
05/16/2023
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