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NPI Code Detail

MEDICARE: DR. JONATHAN SAWAYA LEKOSHERE D.O

MEDICARE: DR. JONATHAN SAWAYA LEKOSHERE D.O
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
1207Q00000XFamily Medicine Physician83474SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2SCK4355214OTHERSCMEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720499775
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN SAWAYA LEKOSHERE D.O
Provider Business Mailing Address
First Line : PO BOX 7411009
Second Line :
City : CHICAGO
State : IL
Zip : 60674-3009
Country : US
Telephone Number : 609-585-1122
Fax Number :
Provider Business Practice Location Address
First Line : 3372 LAURENS RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-5236
Country : US
Telephone Number : 609-585-1122
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2014
Last Update Date : 02/02/2026

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