Provider Demographics
NPI:1841277928
Name:LEWY, PETER R (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:R
Last Name:LEWY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1144 WILMETTE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2604
Mailing Address - Country:US
Mailing Address - Phone:847-256-6480
Mailing Address - Fax:847-256-6482
Practice Address - Street 1:1144 WILMETTE AVE
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2604
Practice Address - Country:US
Practice Address - Phone:847-256-6480
Practice Address - Fax:847-256-6482
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2013-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL0360399172080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D12428Medicare UPIN