Provider Demographics
NPI:1639281926
Name:LEWIS, TAMRA E (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMRA
Middle Name:E
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:22285 PEPPER RD
Mailing Address - Street 2:#201
Mailing Address - City:LAKE BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-0301
Mailing Address - Country:US
Mailing Address - Phone:847-382-5080
Mailing Address - Fax:847-382-0923
Practice Address - Street 1:22285 PEPPER RD
Practice Address - Street 2:#201
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-0301
Practice Address - Country:US
Practice Address - Phone:847-382-5080
Practice Address - Fax:847-382-0923
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL36116474208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036116474Medicaid