Violet Star Lewis
Individual provider Active NPI Nurse's Aide · Kinsman, IL
NPI 1013463611 · NPPES record last updated Sep 1, 2016
Key facts
- NPI
- 1013463611
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- Practice address
- 5025 S Johnny Run Rd
Kinsman, IL 60437-4022 - Phone
- (815) 999-1855
- NPI assigned
- Sep 1, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | IL | Yes |
Addresses
Primary practice location
5025 S Johnny Run Rd
Kinsman, IL 60437-4022
Mailing address
5025 S. Johnny Run Rd.
Kinsman, IL 60437
Phone (815) 999-1855
Other providers in Kinsman, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.