Provider Demographics
NPI:1942261698
Name:JONES, LEWIS F III (OD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:F
Last Name:JONES
Suffix:III
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:IL
Mailing Address - Zip Code:62012-1053
Mailing Address - Country:US
Mailing Address - Phone:618-372-7000
Mailing Address - Fax:618-372-7003
Practice Address - Street 1:101 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:IL
Practice Address - Zip Code:62012-1053
Practice Address - Country:US
Practice Address - Phone:618-372-7000
Practice Address - Fax:618-372-7003
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009304152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN135042OtherGHP
IL2200674OtherUHC
IL560780OtherHEALTHLINK
INIL9304OtherEYE MED
IL05932004OtherBCBS OF IL
IN5676200OtherAETNA
ILU61183OtherMERCY
IL05932004OtherBCBS OF IL
IN5676200OtherAETNA
ILL90819Medicare ID - Type UnspecifiedMEDICARE