Individual
LYNN RAOUL DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 HEALTH CENTER DR, MATTOON, IL 61938-9253
(217) 258-2141
(217) 528-2336
Mailing address
1000 HEALTH CENTER DR, MATTOON, IL 61938-9253
(217) 258-2141
(217) 528-2336
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036044263
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036044263
—
IL
Enumeration date
09/13/2005
Last updated
10/03/2013
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