Individual
LEA L LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 S PRAIRIE AVE, #1101, CHICAGO, IL 60616-4338
(800) 578-7906
(800) 878-5497
Mailing address
1717 S PRAIRIE AVE, #1101, CHICAGO, IL 60616-4338
(800) 578-7906
(800) 878-5497
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180.006056
IL
Other
Enumeration date
08/11/2008
Last updated
08/11/2008
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