Sean Mark Labastida Superticioso (NPI# 1497217350, PAC ID# 6305188921) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1497217350 |
| PAC ID by PECOS | 6305188921 |
| Professional Enrollment ID | I20190501002084 |
| Full Name | Sean Mark Labastida Superticioso |
| Organization Legal Name | CRYSTAL LAKE CENTER FOR CHRONIC PAIN SC |
| Address |
1 S Northwest Hwy B Crystal Lake IL 60014-5800 |
| Phone Number | 8153569409 |
| Gender | M |
| Graduation Year | 2017 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 3173813607 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | M |
| Address | Phone | Organization |
|---|---|---|
| 1 S Northwest Hwy B, Crystal Lake, IL 60014-5800 | 8153569409 | CRYSTAL LAKE CENTER FOR CHRONIC PAIN SC |
| Organization Legal Name | CRYSTAL LAKE CENTER FOR CHRONIC PAIN SC |
| Physicians | 1 |
| Street Address |
1 S NORTHWEST HWY B |
| City | CRYSTAL LAKE |
| State | IL |
| Zip | 60014-5800 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Socha | Chiropractic | 435 Angela Ln, Suite 19, Crystal Lake, IL 60014-1074 | |
| Mark D Lagerkvist | Chiropractic | Chiro One Wellness Center of Crystal Lake Sc | 435 Angela Ln, Suite 19, Crystal Lake, IL 60014-1074 |
| Michael T Burns | Psychologist, Clinical | 610 Crystal Point Dr, Suite 3, Crystal Lake, IL 60014-1400 | |
| Kenneth E Heinrichs | Psychologist, Clinical | 755 E Mcardle Dr, Suite E, Crystal Lake, IL 60014-1717 | |
| Katherine A Galias | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Susan G Swanson | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Christy A Benton | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Roseann C Iverson | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Cynthia G Macdonald | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Michael S Lesser | Family Medicine | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Find all physicians in zip 60014 | |||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | CRYSTAL LAKE + PHYSICAL THERAPY |
Please comment or provide details below to improve the information on Sean Mark Labastida Superticioso.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.