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Contact Information

CRYSTAL LAKE CENTER FOR CHRONIC PAIN SC
1 SOUTH NORTHWEST HIGHWAY
CRYSTAL LAKE, IL60014
 Phone: 815-356-9371
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for CRYSTAL LAKE CENTER FOR CHRONIC PAIN SC · (Female)

NPI # 1154729838
Status Active
Credentials
Entity Individual
Enumeration date 12/12/2014
Last updated 12/12/2014 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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