Individual
JEFFREY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
507 W TOWN CENTER BLVD, CHAMPAIGN, IL 61822-1248
(217) 531-5393
(312) 327-7621
Mailing address
2221 W COLLEGE AVE, NORMAL, IL 61761-2375
(309) 938-4949
(312) 327-7621
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.010600
IL
Other
Enumeration date
08/01/2012
Last updated
08/01/2012
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