Lystila, Aja
Lystila, Aja is an individual health care provider with primary practice located at 2512 Hurst Dr. Family Medicine, Mattoon IL 61938-9388. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Lystila, Aja can be contacted via phone (217) 258-5900.Contact Information
Primary practice address
2512 Hurst Dr. Family Medicine
Mattoon IL 61938-9388
Phone: (217) 258-5900
Fax: (217) 258-5904
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 036119163 | Illinois |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036119163 | Illinois |
Profile Details
| NPI number | 1215159744 |
|---|---|
| LBN Legal business name | Lystila, Aja |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2007 |
| Last updated | Mar 9th, 2015 - about 11 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 | 1215159744 | NPPES |
| Illinois | MEDICAID | 036119163 |
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