Organization
JONATHAN D. LEWIS MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN DAVID LEWIS MD (PRESIDENT)
(773) 271-8345
Entity
Organization
Contact information
Practice address
4753 N BROADWAY ST, SUITE 830, CHICAGO, IL 60640-5266
(773) 271-8345
(773) 275-0318
Mailing address
4753 N BROADWAY ST, SUITE 830, CHICAGO, IL 60640-5266
(773) 271-8345
(773) 275-0318
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
36053771
IL
Other
Enumeration date
07/06/2009
Last updated
07/06/2009
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