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Individual

LINDSAY J MCCRACKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
3860 W OGDEN AVE, CHICAGO, IL 60623-2460
(872) 588-3000
Mailing address
3860 W OGDEN AVE, CHICAGO, IL 60623-2460
(872) 588-3000

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085-002744
IL
363A00000X
Physician Assistant
Primary
085002744
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
085002744
STATE LICENSE
IL
01
1072634
SPECIALTY BOARDS
IL
01
385001585
CS LICENSE
IL
Enumeration date
02/06/2007
Last updated
03/07/2023
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