Healthcare Provider Details

I. General information

NPI: 1467624775
Provider Name (Legal Business Name): LAUREEN LEWIS APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2008
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1512 ARTAIUS PKWY STE 200
LIBERTYVILLE IL
60048-5231
US

IV. Provider business mailing address

1512 ARTAIUS PKWY STE 200
LIBERTYVILLE IL
60048-5231
US

V. Phone/Fax

Practice location:
  • Phone: 478-461-1005
  • Fax: 847-461-1006
Mailing address:
  • Phone: 224-440-2173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number277001152
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: