Michael, John C

Michael, John C is an individual health care provider with primary practice located at 820 E Terra Cotta Ave Ste 247 , Crystal Lake IL 60014-3655. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Michael, John C can be contacted via phone (815) 788-1000.

Contact Information

Primary practice address
820 E Terra Cotta Ave Ste 247 Crystal Lake IL 60014-3655
Fax: (815) 788-2790
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036088212 Illinois

Profile Details

NPI number 1598872160
LBN Legal business name Michael, John C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated Jul 17th, 2009 - about 15 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 1598872160 NPPES
Illinois MEDICAID 0360882121
Illinois Other 0360882122
Illinois Other 05626127
Illinois Other DA3012
Illinois Other 180041333
Illinois Other 036088212

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