Provider Demographics
NPI:1982881256
Name:LEWIS BARR, M.D.,S.C.
Entity Type:Organization
Organization Name:LEWIS BARR, M.D.,S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-231-5286
Mailing Address - Street 1:5 COLUMBINE LN
Mailing Address - Street 2:
Mailing Address - City:RIVERWOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3546
Mailing Address - Country:US
Mailing Address - Phone:708-468-4070
Mailing Address - Fax:
Practice Address - Street 1:5 COLUMBINE LN
Practice Address - Street 2:
Practice Address - City:RIVERWOODS
Practice Address - State:IL
Practice Address - Zip Code:60015-3546
Practice Address - Country:US
Practice Address - Phone:708-468-4070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036045724207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04926607OtherBCBS
IL210384Medicare PIN
ILK11880Medicare PIN
ILC44764Medicare UPIN