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NPI Code Detail

MEDICARE: MADISON LEWIS DPT

MEDICARE: MADISON 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
1225100000XPhysical Therapist1376005TX
22251X0800XOrthopedic Physical Therapist1376005TX

General Provider Information

NPI Number : 1952092488
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON 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 : 9660 BARTLETT CIR STE 708
Second Line :
City : FORT WORTH
State : TX
Zip : 76108-4465
Country : US
Telephone Number : 817-862-9665
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2023
Last Update Date : 01/20/2026

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Directions to “ MADISON LEWIS DPT” Practice Location

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