Provider Demographics
NPI:1508844275
Name:LYON, ESTHER H (DPM)
Entity Type:Individual
Prefix:DR
First Name:ESTHER
Middle Name:H
Last Name:LYON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1590 WEATHERSTONE LN STE 1
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-2059
Mailing Address - Country:US
Mailing Address - Phone:224-448-7060
Mailing Address - Fax:
Practice Address - Street 1:1590 WEATHERSTONE LN STE 1
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-2059
Practice Address - Country:US
Practice Address - Phone:224-448-7060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016004795213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2232662OtherBCBS OF IL
IL2232662OtherBCBS OF IL