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Contact Information

TRACEY L LEWIS, PA-C
102 W KENWOOD AVE STE 100
DECATUR, IL62526
 Phone: 217-872-3800
 Fax: 217-872-0849
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for TRACEY L LEWIS · (Female)

NPI Number 1528439346
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 10/20/2015
Last updated 10/22/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 085005631
  • IL Other F400420323 MEDICARE PIN
Hospital affiliation(s)
  • DECATUR MEMORIAL HOSPITAL - (Acute Care)
    2300 NORTH EDWARD STREET
    DECATUR, IL 62526
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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