Lystila, Aja

Lystila, Aja is an individual health care provider with primary practice located at 2512 Hurst Dr. Family Medicine, Mattoon IL 61938-9388. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Lystila, Aja can be contacted via phone (217) 258-5900.

Contact Information

Primary practice address
2512 Hurst Dr. Family Medicine Mattoon IL 61938-9388
Phone: (217) 258-5900
Fax: (217) 258-5904
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036119163 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036119163 Illinois

Profile Details

NPI number 1215159744
LBN Legal business name Lystila, Aja
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2007
Last updated Mar 9th, 2015 - about 9 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 1215159744 NPPES
Illinois MEDICAID 036119163

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