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General NPI Number Information
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NPI Number | 1407795057
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Entity Type | Organization
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Legal Business Name | JAIME K LEWIS, LLC
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Dates
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Enumeration Date | 03/27/2026
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 21 S LA GRANGE RD
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City | LA GRANGE
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State | IL
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Zip | 60525-2474
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Country | US
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Telephone | 872-222-5844
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 CHATHAM RD STE R
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City | SPRINGFIELD
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State | IL
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Zip | 62704-4188
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/CONSULTANT
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Name | DR. JAIME LEWIS
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Credential | MD, DIPABLM, C-IAYT
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Telephone | 872-222-5844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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