Individual
LEWIS P CARROZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4417 147TH ST, MIDLOTHIAN, IL 60445-2643
(708) 388-3910
(708) 388-3911
Mailing address
4417 147TH ST, MIDLOTHIAN, IL 60445-2643
(708) 388-3910
(708) 388-3911
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
16002973
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1128610001
DMERC
IL
01
—
60001033
BLUE CROSS BLUE SHIELD
IL
Enumeration date
05/04/2006
Last updated
04/12/2013
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