Male or Other

Sean A. Chrystal DO

Hospitalist Physician in Dyer, IN(View on Map)

Full Name

Sean A Chrystal DO

NPI Number

1598968406

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/07/2007

Specialties

(Taxonomies)

Code

208M00000X
207P00000X
207R00000X

Primary Taxonomy

Yes
No
No

Licenses

State

Indiana

License Number

02003500A

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 781076
24 JOLIET ST

City

Detroit
Dyer

State

MI
IN

Postal Code

48278-1076
46311-1705

Country

US
US

Telephone Number

(317) 528-4800
(219) 865-2141

Identifiers

Identifier

036-117518
02003500A
036117518 - CODE 4
200944290

Identifier State

IL
IN
IN
IN

Identifier Issuer

LICENSE
LICENSE
Unknown
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/02/2024

Provider Address

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