Provider Demographics
NPI:1467739193
Name:METCALF, LINDSAY M (MS, ATC)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:M
Last Name:METCALF
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:M
Other - Last Name:AUGUSTINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ATC
Mailing Address - Street 1:2662 MCFARLAND RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-6806
Mailing Address - Country:US
Mailing Address - Phone:815-227-1700
Mailing Address - Fax:815-227-1744
Practice Address - Street 1:2662 MCFARLAND RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6806
Practice Address - Country:US
Practice Address - Phone:815-227-1700
Practice Address - Fax:815-227-1744
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.0027922255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer