Active NPI
Charron McKenzie Lewis, M.D.
- Developmental - Behavioral Pediatrics Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental - Behavioral Pediatrics Physician
- License
- 036143391
- Practice address
- 5841 S Maryland Ave # Mc8016
Chicago, IL 60637 - Phone
- (773) 834-6822
- Fax
- (773) 702-0208
- NPI assigned
- Mar 26, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | 036143391 | IL | Primary |
Addresses
Primary practice location
5841 S Maryland Ave # Mc8016
Chicago, IL 60637
Mailing address
180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036143391 | IL | MD | Developmental - Behavioral Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Metrohealth System | Current | Accepting new patients | |
| The Metrohealth System | Current | Accepting new patients | |
| University Hospitals Medical Group Inc | Current | Accepting new patients | |
| The Metrohealth System | Current | Accepting new patients |
Locations
1299 Industrial Pkwy N
Fl 2
Brunswick, OH 44212
Phone (216) 957-1450
8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024
2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348
2816 E 116th St
Cleveland, OH 44120
Phone (216) 696-3876
11100 Euclid Ave
Cleveland Heights, OH 44106
10 Severance Cir
Cleveland Heights, OH 44118
Phone (216) 297-2600
7800 Pearl Rd
Middleburg Heights, OH 44130
Phone (216) 778-4428
Interoperability endpoints
- clewis36306@ehrdirect.uhhospitals.org
- clewis281200@direct.metrohealth.org
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.
-
- Multi-Specialty Clinic/Center
- Cleveland, OH
- NPI 1053353896
-
- Multi-Specialty Clinic/Center
- Cleveland, OH
- NPI 1669499414
-
- General Acute Care Hospital
- Cleveland, OH
- NPI 1700828852
-
- Pharmacy
- Cleveland, OH
- NPI 1992529911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1831516962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 HARVESTER DR STE 110",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605276686",
"telephone_number": "773-702-1150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE # MC8016",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60637",
"telephone_number": "773-834-6822",
"fax_number": "773-702-0208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "CHARRON",
"middle_name": "MCKENZIE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-26",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0006X",
"taxonomy_group": "",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": "IL",
"license": "036143391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.