Individual
MS. DELLA D CROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
403 E 1ST ST, DIXON, IL 61021
(815) 285-5629
(815) 285-5634
Mailing address
403 E 1ST ST, DIXON, IL 61021-3116
(815) 285-5629
(815) 285-5634
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085000762
IL
363A00000X
Physician Assistant
PA312
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400559193
MEDICARE PTAN
IL
Enumeration date
07/14/2006
Last updated
10/09/2019
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