Individual provider Active NPI

Gregory N Lewis, PSY.D.

  • Clinical Psychologist
  • Wheaton, IL
National Provider Identifier
1063471027
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-004107 Issued in IL
Practice address
7 Blanchard Cir
Suite 201
Wheaton, IL 60189-2039
Phone
(630) 653-2300
Fax
(630) 653-2895
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071004107 IL
Clinical Psychologist 103TC0700X 071-004107 IL Primary

Addresses

Primary practice location

7 Blanchard Cir
Suite 201
Wheaton, IL 60189-2039

Mailing address

7 Blanchard Cir
Suite 201
Wheaton, IL 60189-2037
Phone (630) 653-2300

Other identifiers 1

IdentifierTypeStateIssuer
02215643OtherILBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address glewis@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040527001150 IL Practitioner - Clinical Psychologist 9638150311 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alliance Clinical Associates SCGroup PAC ID 0143202572, 19 clinicians

Practice addresses (Care Compare)

7 Blanchard Cir
Wheaton, IL 60189-2039
Phone (630) 653-2300

7 Blanchard Circle
Suite 201
Wheaton, IL 60189-2039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-004107ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Clinical Associates SC Clinical CurrentSince Jan 1, 2003 Accepting new patients
Cook County CurrentSince Nov 4, 2010 Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Nov 4, 2010 Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

7 Blanchard Cir
Ste 201
Wheaton, IL 60189
Phone (630) 653-2300

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1063471027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BLANCHARD CIR",
            "address_2": "SUITE 201",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601892037",
            "telephone_number": "630-653-2300",
            "fax_number": "630-653-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 BLANCHARD CIR",
            "address_2": "SUITE 201",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601892039",
            "telephone_number": "630-653-2300",
            "fax_number": "630-653-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "GREGORY",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071004107",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-004107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02215643",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "glewis@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.