Individual
DR. ANGELA RICELLE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
606 SILVER LAKE CT, SAVOY, IL 61874-7449
(225) 235-0151
Mailing address
606 SILVER LAKE CT, SAVOY, IL 61874-7449
(225) 235-0151
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
020628
LA
207WX0109X
Neuro-ophthalmology Physician
036.133963
IL
207WX0109X
Neuro-ophthalmology Physician
15245
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1112160
—
LA
Enumeration date
05/16/2006
Last updated
01/25/2020
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