Provider Demographics
NPI:1780729269
Name:LEWIS, NOLAN S (MD)
Entity type:Individual
Prefix:DR
First Name:NOLAN
Middle Name:S
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1440 W NORTH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MELROSE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60160-1422
Mailing Address - Country:US
Mailing Address - Phone:708-343-4280
Mailing Address - Fax:708-343-4287
Practice Address - Street 1:1440 W NORTH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-1422
Practice Address - Country:US
Practice Address - Phone:708-343-4280
Practice Address - Fax:708-343-4287
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand