Crandall, David J

Crandall, David J is an individual health care provider with primary practice located at 22N285 Pepper Rd Suite #111, Lake Barrington IL 60010-5982. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Crandall, David J can be contacted via phone (847) 382-7330.

Contact Information

Primary practice address
22N285 Pepper Rd Suite #111 Lake Barrington IL 60010-5982
Phone: (847) 382-7330
Fax: (847) 382-9654
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036-078801 Illinois

Profile Details

NPI number 1033195383
LBN Legal business name Crandall, David J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2005
Last updated May 7th, 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 1033195383 NPPES
Illinois Other 036078801 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 036078801 BLUE CROSS BLUE SHIELD
Illinois Other 50703 BLUE CROSS BLUE SHIELD
Illinois Other 160019098 BLUE CROSS BLUE SHIELD

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