Healthcare Provider Details

I. General information

NPI: 1962430041
Provider Name (Legal Business Name): COMPREHENSIVE UROLOGIC CARE S C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22285 PEPPER RD SUITE 201
LAKE BARRINGTON IL
60010
US

IV. Provider business mailing address

22285 PEPPER RD SUITE 201
LAKE BARRINGTON IL
60010
US

V. Phone/Fax

Practice location:
  • Phone: 847-382-5080
  • Fax: 847-382-0923
Mailing address:
  • Phone: 847-382-5080
  • Fax: 847-382-0923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number14D0868940
License Number StateIL

VIII. Authorized Official

Name: DR. TAMRA E LEWIS
Title or Position: PRESIDENT
Credential: MD
Phone: 847-382-5080