Individual
LEWIS WASSERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
40 SKOKIE BLVD STE 520, NORTHBROOK, IL 60062-1601
(847) 504-5000
(847) 504-5015
Mailing address
PO BOX 917, NORTHBROOK, IL 60065-0917
(847) 504-5000
(847) 504-5015
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
016004408
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821284506
—
WI
01
—
P01458509
RAILROAD MEDICARE
IL
01
—
P01703994
RAILROAD MEDICARE
WI
Enumeration date
09/17/2007
Last updated
01/22/2019
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