DR. CHARRON MCKENZIE LEWIS (NPI# 1831516962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831516962 |
| Entity Type | Individual |
| Full Name | DR. CHARRON MCKENZIE LEWIS |
| Credential | M.D. |
| Practice Address |
5841 S Maryland Ave # Mc8016 Chicago IL 60637 |
| Mailing Address |
180 Harvester Dr Ste 110 Burr Ridge IL 60527-6686 |
| Practice Telephone | 7738346822 |
| Practice Fax Number | 7737020208 |
| Mailing Telephone | 7737021150 |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2018-09-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
036143391 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
5841 S MARYLAND AVE # MC8016 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194719690 | Anjali S Rao | Pediatrics | 5841 S Maryland Ave # Mc8016, Chicago, IL 60637-1443 | 2005-09-12 |
| 1700404993 | Mohamed Taha | Pediatrics | 5841 S Maryland Ave # Mc8016, Chicago, IL 60637-1443 | 2020-07-14 |
| 1720609563 | Lestella Dorothy Bell | Pediatrics | 5841 S Maryland Ave # Mc8016, Chicago, IL 60637-1443 | 2020-05-04 |
| 1639790553 | Joshua Chang | Pediatrics | 5841 S Maryland Ave # Mc8016, Chicago, IL 60637-1443 | 2020-05-01 |
| 1871113795 | Parina Maniar | Pediatrics | 5841 S Maryland Ave # Mc8016, Chicago, IL 60637-1443 | 2020-04-21 |
| 1194345983 | Chukwuemeka Okorie Igwe | Pediatrics | 5841 S Maryland Ave # Mc8016, Chicago, IL 60637-1443 | 2020-04-21 |
| 1790305662 | Lara Hoover | Pediatrics | 5841 S Maryland Ave # Mc8016, Chicago, IL 60637-1443 | 2020-04-21 |
| 1124648084 | Kevin Carey | Pediatrics | 5841 S Maryland Ave # Mc8016, Chicago, IL 60637-1443 | 2020-04-21 |
| 1316502214 | Monica Marie Pomaville | Pediatrics | 5841 S Maryland Ave # Mc8016, Chicago, IL 60637-1443 | 2019-05-06 |
| 1669036224 | Jacqueline Elizabeth Pasulka | Pediatrics | 5841 S Maryland Ave # Mc8016, Chicago, IL 60637-1443 | 2019-04-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386263234 | Pooja Ramnani | Pharmacist | 5841 S Maryland Ace, Chicago, IL 60637 | 2020-04-10 |
| 1780220079 | Tara Coleman | Non-emergency Medical Transport (VAN) | 808 E. 63rd Street, Suite 135, Chicago, IL 60637 | 2019-11-21 |
| 1366003501 | Valerie Silas | Case Management | 6330 S King Drive, Chicago, IL 60637 | 2019-06-27 |
| 1205391620 | Derek Joseph Fiedler | Anesthesiology | University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 | 2019-02-11 |
| 1821573072 | Ugochinyere Ohaja | Registered Nurse | 5656 South Maryland Avenue, Chicago, IL 60637 | 2018-10-03 |
| 1053899138 | Won Hee Oh | Physician Assistant | 5841 S. Maryland Ave., Mc5040, Chicago, IL 60637 | 2018-08-01 |
| 1558854695 | Rasidat Adeduntan | Internal Medicine | 5841 S. Maryland Avenue, [7082], Chicago, IL 60637 | 2018-06-13 |
| 1194235283 | Melissa Ann Arangoa | Registered Nurse | 5841 S. Maryland Ave, Mc 1083, Chicago, IL 60637 | 2017-10-03 |
| 1558880633 | Marni Harris | Optometrist | 5841 S Maryland Ave # S421, Chicago, IL 60637 | 2017-09-11 |
| 1992235105 | Vidya Mahavadi | Pediatrics | 5841 S. Maryland Avenue, Mail Code 8016, Chicago, IL 60637 | 2017-06-20 |
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| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720625601 | Shane Rafferty | Pediatrics | 4852 N Rockwell St Apt 2, Chicago, IL 60625-6521 | 2019-12-10 |
| 1376930750 | Prudence Hartwell | Pediatrics | 5841 S Maryland Ave # Mc0900, Chicago, IL 60637 | 2015-04-23 |
| 1942598891 | Sotiria E. Moschovis | Pediatrics | 6127 N. Leader Ave., Chicago, IL 60646 | 2011-07-13 |
| 1720142995 | Peter Joseph Smith Sr. | Pediatrics | 950 E. 61st Street, Ssc, Suite 207, Chicago, IL 60637 | 2006-12-21 |
| 1134644834 | Shevia Morris | Pediatrics | 5116 N Nordica Ave, Chicago, IL 60656-3606 | 2017-08-03 |
| 1982066957 | Maria Gabriela Balsa Guerrero | Pediatrics | 5841 S Maryland Ave # Mc8016, Chicago, IL 60637-1443 | 2016-03-28 |
| 1922484823 | Tanuja Kothinti | Pediatrics | 5841 S Maryland Ave, Chicago, IL 60637 | 2015-08-03 |
| 1174790745 | Sarah Courtney Bauer | Pediatrics | 225 E Chicago Ave, Box 2, Chicago, IL 60611-2605 | 2008-05-13 |
| 1194990705 | Karin Elizabeth Vander Ploeg Booth | Pediatrics | 950 E 61st St, Section of Dbp Ssc Room 207, Chicago, IL 60637-2623 | 2008-04-24 |
| 1659421691 | Lawrence A Gray | Pediatrics | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2007-01-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.