MEDICARE: LEWIS S BLUMENTHAL 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	207V00000X	Obstetrics & Gynecology Physician	036059833	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

General Provider Information

NPI Number	:	1750366209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEWIS S BLUMENTHAL MD

Provider Business Mailing Address
First Line	:	55 E WASHINGTON ST
Second Line	:	SUITE 3700
City	:	CHICAGO
State	:	IL
Zip	:	60602-2103
Country	:	US
Telephone Number	:	312-263-5517
Fax Number	:	312-263-5565

Provider Business Practice Location Address
First Line	:	55 E WASHINGTON ST
Second Line	:	SUITE 3700
City	:	CHICAGO
State	:	IL
Zip	:	60602-2103
Country	:	US
Telephone Number	:	312-263-5517
Fax Number	:	312-263-5565

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

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	07/08/2007

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Directions to “ LEWIS S BLUMENTHAL MD” Practice Location

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