Provider Demographics
NPI:1447296413
Name:CROWSON, LILA ANN (MPT)
Entity type:Individual
Prefix:
First Name:LILA
Middle Name:ANN
Last Name:CROWSON
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:LILA
Other - Middle Name:ANN
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:2 ELM CREEK DR
Mailing Address - Street 2:APT 104
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5267
Mailing Address - Country:US
Mailing Address - Phone:504-231-5490
Mailing Address - Fax:
Practice Address - Street 1:1030 W HIGGINS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60195-3200
Practice Address - Country:US
Practice Address - Phone:847-885-0078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAP00215809OtherMEDICARE RR
LA4C472Medicare ID - Type Unspecified