Provider Demographics
NPI:1285688820
Name:MA, LINDSEY A (MD)
Entity Type:Individual
Prefix:MR
First Name:LINDSEY
Middle Name:A
Last Name:MA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3300 W WILLOW KNOLLS DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-8121
Mailing Address - Country:US
Mailing Address - Phone:309-683-0200
Mailing Address - Fax:309-683-0201
Practice Address - Street 1:3300 W WILLOW KNOLLS DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-8121
Practice Address - Country:US
Practice Address - Phone:309-683-0200
Practice Address - Fax:309-683-0201
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036083144207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL07232118OtherBCBS OF ILLINOIS
ILJOHN DEEREOtherIL0101/203158434-01
ILHEALTHLINKOther239068
ILP00272393/DE1123OtherRAILROAD MEDICARE
ILF58390Medicare UPIN
ILP00272393/DE1123OtherRAILROAD MEDICARE