Individual
GLEN A LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6955 NORTH AVE STE G3, OAK PARK, IL 60302-1052
(773) 213-0132
Mailing address
6955 NORTH AVE STE G3, OAK PARK, IL 60302-1052
(773) 213-0132
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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