Crutcher, Lisa D

Crutcher, Lisa D is an individual health care provider with primary practice located at 1830 Mediterranean Dr , Sycamore IL 60178-3144. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Crutcher, Lisa D can be contacted via phone (815) 306-2700.

Contact Information

Primary practice address
1830 Mediterranean Dr Sycamore IL 60178-3144
Phone: (815) 306-2700
Fax: (815) 306-2715
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-104449 Illinois

Profile Details

NPI number 1841261013
LBN Legal business name Crutcher, Lisa D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Aug 14th, 2013 - about 11 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 1841261013 NPPES
Illinois Other 920540044 MEDICARE PTAN (INDIVIDUAL)
Illinois MEDICAID 036104449 MEDICARE PTAN (INDIVIDUAL)
Illinois Other 920540 MEDICARE PTAN (INDIVIDUAL)

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