MEDICARE: STEVEN JOSEPH LEWIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	036119342	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	875921	OTHER	IL	HEALTHLINK

General Provider Information

NPI Number	:	1598763880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN JOSEPH LEWIS MD

Provider Business Mailing Address
First Line	:	45 WOODLAND TRL
Second Line	:
City	:	ROCHESTER
State	:	IL
Zip	:	62563-9553
Country	:	US
Telephone Number	:	217-836-0766
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 WOODLAND TRL
Second Line	:
City	:	ROCHESTER
State	:	IL
Zip	:	62563-9553
Country	:	US
Telephone Number	:	217-836-0766
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	01/17/2025

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