Distasio, Louis Thomas
Distasio, Louis Thomas is an individual health care provider with primary practice located at 716 S 2Nd St. , Springfield IL 62704. He recently has only one registered license in Other Service Providers / Acupuncturist, which is considered as his primary health care specialty. Distasio, Louis Thomas can be contacted via phone (217) 544-8118.Contact Information
Primary practice address
716 S 2Nd St.
Springfield IL 62704
Phone: (217) 544-8118
Fax: (217) 544-8008
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Acupuncturist | 171100000X | 198000025 | Illinois |
Profile Details
| NPI number | 1629153085 |
|---|---|
| LBN Legal business name | Distasio, Louis Thomas |
| Credentials | Licensed Acupuncturist (LAC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2006 |
| Last updated | Dec 8th, 2020 - about 6 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 | 1629153085 | NPPES |
| Illinois | Other | 8482034 | BLUE CROSS BLUE SHIELD |
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