Individual
MARK LYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2850 W 95TH ST STE 106, EVERGREEN PARK, IL 60805-2703
(708) 888-8287
(708) 274-4027
Mailing address
2850 W 95TH ST STE 106, EVERGREEN PARK, IL 60805-2703
(708) 888-8287
(708) 274-4027
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036116228
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02232706
BCBS
—
05
—
036116228
—
IL
01
—
211475
MEDICAN PTAN
—
01
—
DG0826
MEDICARE RAILROAD GROUP NUMBER
—
01
—
P00467991
MEDICARE RAILROAD PTAN
—
Enumeration date
05/24/2007
Last updated
04/16/2025
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