Lewis, Mary Elizabeth

Lewis, Mary Elizabeth is an individual health care provider with primary practice located at 5401 N Knoxville Ave Ste 208 , Peoria IL 61614-5021. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Lewis, Mary Elizabeth can be contacted via phone (309) 672-4908.

Contact Information

Primary practice address
5401 N Knoxville Ave Ste 208 Peoria IL 61614-5021
Phone: (309) 672-4908
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 036066331 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 209002626 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209002626 Illinois

Profile Details

NPI number 1578579470
LBN Legal business name Lewis, Mary Elizabeth
Credentials C-FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Dec 4th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578579470 NPPES
Illinois Other 7215059 BCBS PPO
Illinois Other 069915 BCBS PPO
Illinois Other 500014413 BCBS PPO
Illinois Other 563097 BCBS PPO
Illinois Other IL01Q8 BCBS PPO

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