Individual
ALICE-GRAY LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4140 SOUTHWEST HWY, HOMETOWN, IL 60456-1135
(708) 422-5700
(708) 422-8225
Mailing address
4140 SOUTHWEST HWY, HOMETOWN, IL 60456-1135
(708) 422-5700
(708) 422-8225
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125.072035
IL
Other
Enumeration date
05/23/2018
Last updated
02/11/2022
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