Crouch, Nathan A
Crouch, Nathan A is an individual health care provider with primary practice located at 3101 Fields South Dr , Champaign IL 61822-3743. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Crouch, Nathan A can be contacted via phone (217) 366-1250.Contact Information
Primary practice address
3101 Fields South Dr
Champaign IL 61822-3743
Phone: (217) 366-1250
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046009653 | Illinois |
Profile Details
| NPI number | 1750386215 |
|---|---|
| LBN Legal business name | Crouch, Nathan A |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 20th, 2005 |
| Last updated | Jan 6th, 2022 - about 4 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 | 1750386215 | NPPES |
| Illinois | Other | 05832113 | BLUE CROSS |
| Illinois | MEDICAID | 046009653 | BLUE CROSS |
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