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General NPI Number Information
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NPI Number | 1336223197
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Entity Type | Individual
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Provider Name | JOHN MICHAEL LEWENCZUK DC
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/12/2010
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Provider Practice Location Address
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Address Line | 2137 63RD STREET
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City | DOWNERS GROVE
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State | IL
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Zip | 60516
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Country | US
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Telephone | 630-271-9900
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Fax | 630-271-9045
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Provider Business Mailing Address
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Address Line | 2137 63RD ST
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City | DOWNERS GROVE
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State | IL
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Zip | 60516
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Country | US
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Telephone | 630-271-9900
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Fax | 630-271-9045
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038007330
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3880
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1856
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License Number State | MA
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