Provider Demographics
NPI:1467210559
Name:HOWARD, CRYSTAL (CRTT)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:CRTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15410 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:DOLTON
Mailing Address - State:IL
Mailing Address - Zip Code:60419-2729
Mailing Address - Country:US
Mailing Address - Phone:773-563-0081
Mailing Address - Fax:
Practice Address - Street 1:15410 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DOLTON
Practice Address - State:IL
Practice Address - Zip Code:60419-2729
Practice Address - Country:US
Practice Address - Phone:773-563-0081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19401465227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified