Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Crystal Vaughn Manse, MD

Individual provider General Practice Physician · NPI 1366702870

Dr. Crystal Vaughn Manse, MD is a General Practice Physician in O Fallon, Illinois. Works from 3 locations. Licensed in Illinois and Virginia.

Licensed in
IL, VA
In the registry since
2012
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269-1284
Phone: (618) 233-5480
Fax: (618) 222-4792
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 375th Medical Group, Scott Afb, IL 62225 — (618) 256-7799
  • 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 — (210) 292-7805

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 036139867 (IL)
General Practice Physician Taxonomy 208D00000X · Licence 0101255760 (VA)
Hospitalist Physician Taxonomy 208M00000X · Licence 036139867 (IL)

Record details

NPI number1366702870
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 18, 2012
Last updated in NPPESSeptember 12, 2024
Certification dateSeptember 12, 2024

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