Provider Demographics
NPI:1790742542
Name:LEWITZ, AMY M (MS RN CS APRN BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:LEWITZ
Suffix:
Gender:F
Credentials:MS RN CS APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6942 N KILPATRICK
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-2414
Mailing Address - Country:US
Mailing Address - Phone:847-676-9260
Mailing Address - Fax:
Practice Address - Street 1:6942 N KILPATRICK
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-2414
Practice Address - Country:US
Practice Address - Phone:847-676-9260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209001351163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
444820Medicare ID - Type Unspecified
P16471Medicare UPIN