Provider Demographics
NPI:1669442174
Name:LEWIS, RACHEL BOOTH (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:BOOTH
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 SHERIDAN PL
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1725
Mailing Address - Country:US
Mailing Address - Phone:619-829-8809
Mailing Address - Fax:
Practice Address - Street 1:2801 SHERIDAN PL
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1725
Practice Address - Country:US
Practice Address - Phone:619-829-8809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361298362085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging