MEDICARE: LILLIAN LEWIS DPT

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	225100000X	Physical Therapist
2	225100000X	Physical Therapist	6599	OK

General Provider Information

NPI Number	:	1841029899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILLIAN LEWIS DPT

Provider Business Mailing Address
First Line	:	2122 YORK RD STE 300
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1925
Country	:	US
Telephone Number	:	630-575-1980
Fax Number	:

Provider Business Practice Location Address
First Line	:	1113 S DOUGLAS BLVD STE C
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-5245
Country	:	US
Telephone Number	:	405-931-2518
Fax Number	:

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

Provider Enumeration Date	:	07/29/2024
Last Update Date	:	10/03/2024

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Directions to “ LILLIAN LEWIS DPT” Practice Location

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