Basic Information
| Provider Information | |||||||||
| NPI: | 1750674271 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEWIS | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD, MPH | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | SMITH | ||||||||
| OtherFirstName: | CHRISTINA | ||||||||
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| OtherCredential: | CHRISTINA SMITH | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3901 RAINBOW BLVD | ||||||||
| Address2: | MAILSTOP 1034 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135886670 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8600 STATE ROUTE 91 STE 250 | ||||||||
| Address2: | |||||||||
| City: | PEORIA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 616157831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3096925393 | ||||||||
| FaxNumber: | 3096922538 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2011 | ||||||||
| LastUpdateDate: | 08/11/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A135938 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 04-44740 | KS | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.