Lyle, Herman Oscar

Lyle, Herman Oscar is an individual health care provider with primary practice located at 6563 Wards Mill Road , Marion IL 62959-0820. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Lyle, Herman Oscar can be contacted via phone (618) 993-3692.

Contact Information

Primary practice address
6563 Wards Mill Road Marion IL 62959-0820
Phone: (618) 993-3692
Fax: (618) 964-2056
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-054539 Illinois

Profile Details

NPI number 1275530230
LBN Legal business name Lyle, Herman Oscar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2005
Last updated Jun 4th, 2008 - about 17 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 1275530230 NPPES
Illinois Other 036076429 BCBS
Illinois Other 1275530230 BCBS
Illinois MEDICAID 036076429 BCBS

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