Christopher M Northern PA

NPI 1043300767 - Physician Assistant - 363A00000X

NPI Details
NPI 1043300767
Gender Male
Enumeration Date 10/13/2006
Last Updated 04/24/2009
Entity Type Individual
Active Over 10 years ago
Practice Location
360 STATION DR
CRYSTAL LAKE IL, 60014-7978, US
Phone (815) 356-2330
Fax (815) 477-9826
Business Location
13707 W JACKSON ST
WOODSTOCK IL, 60098-3188, US
Phone (815) 337-1871
Fax (815) 338-6297
Toxanomy
Taxonomy Code 363A00000X
License State Wisconsin
License Number 1898-023
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According to our database, Christopher M Northern PA NPI is 1043300767, taxonomy code is 363A00000X and license number is 1898-023, license state is located at Wisconsin. Christopher M Northern PA physically located at 360 Station Dr, Crystal Lake IL, 60014-7978. NPI Number Christopher M Northern PA has the Individual type.

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1043300767 NPI number is provided on an as is basis without warranty of any kind. 1043300767 is maintained by the National Plan & Provider Enumeration System. The contents of Christopher M Northern PA are for informational purposes only.