Individual
DR. ANGELA S LEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HSPP
Contact information
Practice address
8770 W BRYN MAWR AVE, SUITE 1300, CHICAGO, IL 60631-3515
(877) 807-5120
(708) 460-4120
Mailing address
8770 W BRYN MAWR AVE, SUITE 1300, CHICAGO, IL 60631-3515
(877) 807-5120
(708) 460-4120
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041121A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200200710A
—
IN
01
—
K46442
MEDICARE PTAN
IL
Enumeration date
03/17/2006
Last updated
06/16/2009
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