Organization
EDMUND J LEWIS M D & ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANISH TANNA MD (PRESIDENT)
(630) 573-5000
Entity
Organization
Contact information
Practice address
104 S ASHLAND AVE, CHICAGO, IL 60607-2402
(312) 850-8434
(312) 829-3887
Mailing address
PO BOX 72362, CLEVELAND, OH 44192-0002
(331) 216-1171
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
36045051
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1615381
BCBS P PROVIDER NUMBER
IL
Enumeration date
08/13/2006
Last updated
02/04/2026
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