Otteman, Crystal J

Otteman, Crystal J is an individual health care provider with primary practice located at 25 N Winfield Rd , Winfield IL 60190-1295. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as her primary health care specialty. Otteman, Crystal J can be contacted via phone (630) 690-4993.

Contact Information

Primary practice address
25 N Winfield Rd Winfield IL 60190-1295
Phone: (630) 690-4993
Fax: (630) 690-2293
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 036086512 Illinois

Profile Details

NPI number 1174578629
LBN Legal business name Otteman, Crystal J
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2006
Last updated Feb 4th, 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 1174578629 NPPES
Illinois Other 206147 MEDICARE PTAN (GROUP)
Illinois Other 1617373 MEDICARE PTAN (GROUP)
Illinois Other F400188340 MEDICARE PTAN (GROUP)
Illinois MEDICAID 036086512 MEDICARE PTAN (GROUP)

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