Lynn Raoul Dale, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036044263 Issued in IL

Practice address

1000 Health Center Dr
Mattoon, IL 61938-9253

Phone

(217) 258-2141

Fax

(217) 528-2336

NPI assigned

Sep 13, 2005

Last updated

Oct 3, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hospital & Medical Foundation of Paris, Inc.

  dba Horizon Health

  • Clinic/Center
  • Paris, IL
  • NPI 1629280367
  NPD (past)
• Lakeland Radiologists LTD

  • Diagnostic Radiology Physician
  • Charleston, IL
  • NPI 1891782090
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1760477004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HEALTH CENTER DR",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389253",
            "telephone_number": "217-258-2141",
            "fax_number": "217-528-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HEALTH CENTER DR",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389253",
            "telephone_number": "217-258-2141",
            "fax_number": "217-528-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "LYNN",
        "middle_name": "RAOUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036044263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036044263",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crossing Dental Care PC (Cross County Dental Center)
• Alexander Crum, BA
• Lori Cudone, M.D.
• Naomi D'Entremont, OD
• Tammy Dahlke, LSW
• Parys Daniels, BA
• Kinsey Elizabeth Dansdill
• Danville Vamc
• Brenda Davis
• Michael Vernon Davis I

• Diagnostic Radiology Physician in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.