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
Phone: (815) 788-1000
Fax: (815) 788-2790
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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