Provider Demographics
NPI:1306925268
Name:LEWIS, JULIET LYNNE (OD)
Entity type:Individual
Prefix:DR
First Name:JULIET
Middle Name:LYNNE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JULIET
Other - Middle Name:LYNNE
Other - Last Name:NAJEM TRITSIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:420 GREEN BAY RD
Mailing Address - Street 2:
Mailing Address - City:KENILWORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60043-1001
Mailing Address - Country:US
Mailing Address - Phone:847-853-1111
Mailing Address - Fax:847-853-7400
Practice Address - Street 1:3100 W PETERSON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3721
Practice Address - Country:US
Practice Address - Phone:773-743-2122
Practice Address - Fax:773-743-2269
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-8599152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist