Healthcare Provider Details

I. General information

NPI: 1316950223
Provider Name (Legal Business Name): DAVID S LEWIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 SOUTHWEST HWY
PALOS HEIGHTS IL
60463-1029
US

IV. Provider business mailing address

2300 N LINCOLN PARK W #622
CHICAGO IL
60614-3456
US

V. Phone/Fax

Practice location:
  • Phone: 708-361-0220
  • Fax: 708-923-3611
Mailing address:
  • Phone: 773-909-0379
  • Fax: 708-923-3611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036-092770
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: