Lundeberg, John D

Lundeberg, John D is an individual health care provider with primary practice located at 2 S Hospital Dr , Murphysboro IL 62966-3333. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Lundeberg, John D can be contacted via phone (618) 684-3156.

Contact Information

Primary practice address
2 S Hospital Dr Murphysboro IL 62966-3333
Phone: (618) 684-3156
Fax: (618) 529-0529
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 041181507 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209001325 Illinois

Profile Details

NPI number 1386638906
LBN Legal business name Lundeberg, John D
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2005
Last updated Apr 13th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386638906 NPPES
Illinois Other 214881 GROUP PTAN

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