| Sean A Chrystal, DO | |
| 24 Joliet St, Dyer, IN 46311-1705 | |
| (219) 852-1524 | |
| (219) 933-2288 | 
| Full Name | Sean A Chrystal | 
|---|---|
| Gender | Male | 
| Speciality | Hospitalist | 
| Location | 24 Joliet St, Dyer, Indiana | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1598968406 | NPI | - | NPPES | 
| 02003500A | Other | IN | LICENSE | 
| 036-117518 | Other | IL | LICENSE | 
| 200944290 | Medicaid | IN | |
| 036117518 - CODE 4 | Medicaid | IN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207P00000X | Emergency Medicine | 02003500A (Indiana) | Secondary | 
| 207R00000X | Internal Medicine | 02003500A (Indiana) | Secondary | 
| 208M00000X | Hospitalist | 02003500A (Indiana) | Primary | 
| Entity Name | Franciscan Physician Network | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1225327984 PECOS PAC ID: 3072790682 Enrollment ID: O20110608000486 | 
| Entity Name | App Of Indiana Ed Pllc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1740822212 PECOS PAC ID: 2961835400 Enrollment ID: O20191213001639 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Sean A Chrystal, DO Po Box 781076, Detroit, MI 48278-1076 Ph: (317) 528-4800 | Sean A Chrystal, DO 24 Joliet St, Dyer, IN 46311-1705 Ph: (219) 852-1524 | 
| Chao Gong, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 24 Joliet St, Dyer, IN 46311 Phone: 219-865-2141 Fax: 219-852-2502 | |
| David B Lemke, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 24 Joliet St, Dyer, IN 46311 Phone: 219-852-1524 Fax: 219-933-2288 |