Individual
MR. JENNAIRE TIMOY LEWARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 W. PARK STREET, URBANA, IL 61801
(217) 383-4633
Mailing address
611 W. PARK STREET, URBANA, IL 61801
(217) 383-4633
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125.77899
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/16/2021
Last updated
02/14/2024
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