Active NPI
Johnathan Patrick Lewis, DO
- Emergency Medicine Physician
- Oak Park, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036163696
- Practice address
- 520 S Maple Ave
Oak Park, IL 60304-1022 - Phone
- (708) 660-5997
- Fax
- (630) 660-2251
- NPI assigned
- Jun 14, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 5151014031 | MI | |
| Emergency Medicine Physician | 207P00000X | 036163696 | IL | Primary |
Addresses
Primary practice location
520 S Maple Ave
Oak Park, IL 60304-1022
Mailing address
520 S Maple Ave
Oak Park, IL 60304-1022
Phone (708) 660-5997
Other practice location 1
1700 Clinton St
Muskegon, MI 49442-5502
Phone (231) 728-4936
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Michigan State University College of Osteopathic Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
520 S Maple Ave
Oak Park, IL 60304-1022
Phone (708) 660-2240
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036163696 | IL | MD | Emergency Medicine Physician |
| 5151014031 | MI | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rush University Medical Group | Emergency Medicine | Current | Accepting new patients |
| Rush Oak Park ER Physicians Group | Current | Accepting new patients | |
| Mercy Health Partners | Current | Accepting new patients | |
| Mercy Health Partners | Current | Accepting new patients | |
| Rush University Medical Center | Current | Accepting new patients | |
| Lake Michigan Emergency Specialists, PLLC | Emergency Medicine | Current | Accepting new patients |
Locations
75 Remittance Dr
Dept 1611
Chicago, IL 60675
1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138
1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875
75 Remittance Dr
Dept 1620
Chicago, IL 60675
520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300
1700 Clinton St
Muskegon, MI 49442
Phone (231) 726-3511
71 Bevier St
Shelby, MI 49455
Phone (231) 861-2172
72 S State St
Shelby, MI 49455
Phone (231) 728-4601
905 E Colby St
Whitehall, MI 49461
Phone (231) 672-8050
Organizations & group practices 6
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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Oak Park, IL
- NPI 1447260880
-
dba Rush University Internists
- Internal Medicine Physician
- Chicago, IL
- NPI 1093819542
Emergency Medicine
-
- Emergency Medicine Physician
- Muskegon, MI
- NPI 1124574520
-
dba Rush Oak Brook
- Internal Medicine Physician
- Oak Brook, IL
- NPI 1801375696
-
dba Trinity Health Medical Group
- Certified Registered Nurse Anesthetist
- Shelby, MI
- NPI 1154910172
-
dba Trinity Health Medical Group
- Family Medicine Physician
- Whitehall, MI
- NPI 1801208087
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Oak Park, IL
- NPI 1558391706
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684195200000",
"number": "1417517236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 S MAPLE AVE",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603041022",
"telephone_number": "708-660-5997",
"fax_number": "630-660-2251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 S MAPLE AVE",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603041022",
"telephone_number": "708-660-5997",
"fax_number": "630-660-2251"
}
],
"practiceLocations": [
{
"address_1": "1700 Clinton St",
"address_purpose": "LOCATION",
"city": "Muskegon",
"state": "MI",
"postal_code": "494425502",
"country_code": "US",
"telephone_number": "231-728-4936",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEWIS",
"first_name": "JOHNATHAN",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-14",
"last_updated": "2023-05-16",
"certification_date": "2023-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "5151014031",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036163696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oak Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.