Individual
LEWIS T MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 JOHN DEERE RD BLDG 2, MOLINE, IL 61265-6898
(309) 517-3036
(309) 797-1088
Mailing address
420 NE GLEN OAK AVE STE 401, PEORIA, IL 61603-3112
(309) 676-8123
(309) 676-8455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R-10643
IA
207RN0300X
Nephrology Physician
Primary
MD-47669
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036155111
—
IL
05
—
2504957
—
IA
Enumeration date
06/27/2016
Last updated
02/04/2026
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