Sean A Chrystal, DO | |
24 Joliet St, Dyer, IN 46311-1705 | |
(219) 865-2141 | |
(219) 933-2288 |
Full Name | Sean A Chrystal |
---|---|
Gender | Male |
Speciality | Hospitalist |
Location | 24 Joliet St, Dyer, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598968406 | NPI | - | NPPES |
036-117518 | Other | IL | LICENSE |
02003500A | Other | IN | LICENSE |
036117518 - CODE 4 | Medicaid | IN | |
200944290 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 02003500A (Indiana) | Secondary |
207R00000X | Internal Medicine | 02003500A (Indiana) | Secondary |
208M00000X | Hospitalist | 02003500A (Indiana) | Primary |
Entity Name | App Of Indiana Ed, Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740822212 PECOS PAC ID: 2961835400 Enrollment ID: O20191213001639 |
Mailing Address | Practice Location Address |
---|---|
Sean A Chrystal, DO Po Box 781076, Detroit, MI 48278-1076 Ph: (317) 528-4800 | Sean A Chrystal, DO 24 Joliet St, Dyer, IN 46311-1705 Ph: (219) 865-2141 |
Jeannie Boram Ur, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 24 Joliet St, Dyer, IN 46311 Phone: 219-865-2141 Fax: 219-933-2288 | |
Chao Gong, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 24 Joliet St, Dyer, IN 46311 Phone: 219-865-2141 Fax: 219-852-2502 | |
Dr. Harold Leroy Rahming, MD Hospitalist Medicare: Medicare Enrolled Practice Location: 24 Joliet St, Dyer, IN 46311 Phone: 219-865-2141 Fax: 219-933-2288 | |
Dr. Chike Olisa Nwokolo, DO Hospitalist Medicare: Medicare Enrolled Practice Location: 24 Joliet St, Dyer, IN 46311 Phone: 219-865-2141 Fax: 219-933-2288 |