Healthcare Provider Details

I. General information

NPI: 1639281926
Provider Name (Legal Business Name): TAMRA E LEWIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22285 PEPPER RD #201
LAKE BARRINGTON IL
60010-0301
US

IV. Provider business mailing address

22285 PEPPER RD #201
LAKE BARRINGTON IL
60010-0301
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 Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number036116474
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number36116474
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: