Daniels, Crystal Banks

Daniels, Crystal Banks is an individual health care provider with primary practice located at 228 E Lake St , Addison IL 60101-2889. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Daniels, Crystal Banks can be contacted via phone (630) 835-1430.

Contact Information

Primary practice address
228 E Lake St Addison IL 60101-2889
Fax: (630) 835-1433
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301057725 Michigan

Profile Details

NPI number 1962400556
LBN Legal business name Daniels, Crystal Banks
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2005
Last updated Feb 18th, 2021 - about 5 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 1962400556 NPPES
Michigan MEDICAID 4483489

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