Individual
DR. WILLIAM LYTOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, MD
Contact information
Practice address
200 STAHLHUT DR, LINCOLN, IL 62656-5066
(217) 528-7541
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
057392
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036144534
MEDICAL LICENSE
IL
01
—
057392
MEDICAL LICENSE
GA
Enumeration date
05/01/2006
Last updated
12/11/2020
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