Provider Demographics
NPI:1316576804
Name:ISRAELS, LINDSAY GRACE (DO)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:GRACE
Last Name:ISRAELS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:GRACE
Other - Last Name:SCHICHTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:5900 BYRON CENTER AVE SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-9606
Mailing Address - Country:US
Mailing Address - Phone:616-252-7200
Mailing Address - Fax:616-252-4953
Practice Address - Street 1:2917 PORT SHELDON ST
Practice Address - Street 2:
Practice Address - City:HUDSONVILLE
Practice Address - State:MI
Practice Address - Zip Code:49426-9314
Practice Address - Country:US
Practice Address - Phone:616-252-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101027248207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program