Lonnie Crawford
Individual provider Active NPI Driver · Chicago, IL
NPI 1760970883 · NPPES record last updated Apr 24, 2018
Key facts
- NPI
- 1760970883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- C61652049205 (IL)
- Practice address
- 1019 N Menard Ave
Chicago, IL 60651-2665 - Phone
- (708) 506-0093
- NPI assigned
- Apr 24, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C61652049205 | IL | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | C61652049205 | IL | Yes |
Addresses
Primary practice location
1019 N Menard Ave
Chicago, IL 60651-2665
Mailing address
1019 N Menard Ave
Chicago, IL 60651-2665
Phone (708) 506-0093
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.