Crouch, Nathan A

Crouch, Nathan A is an individual health care provider with primary practice located at 3101 Fields South Dr , Champaign IL 61822-3743. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Crouch, Nathan A can be contacted via phone (217) 366-1250.

Contact Information

Primary practice address
3101 Fields South Dr Champaign IL 61822-3743
Phone: (217) 366-1250
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046009653 Illinois

Profile Details

NPI number 1750386215
LBN Legal business name Crouch, Nathan A
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Jan 6th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750386215 NPPES
Illinois Other 05832113 BLUE CROSS
Illinois MEDICAID 046009653 BLUE CROSS

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