Lyon, Mark
Lyon, Mark is an sole proprietor health care provider with primary practice located at 2850 W 95Th St Suite 302, Evergreen Park IL 60805-2735. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Lyon, Mark can be contacted via phone (708) 422-2242.Contact Information
Primary practice address
2850 W 95Th St Suite 302
Evergreen Park IL 60805-2735
Phone: (708) 422-2242
Fax: (708) 422-2270
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 036116228 | Illinois |
Profile Details
| NPI number | 1831300748 |
|---|---|
| LBN Legal business name | Lyon, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 24th, 2007 |
| Last updated | Dec 26th, 2023 - about 3 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 | 1831300748 | NPPES |
| Other | 02232706 | BCBS | |
| Other | P00467991 | BCBS | |
| Other | 211475 | BCBS | |
| MEDICAID | 036116228 | BCBS | |
| Other | DG0826 | BCBS |
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