Provider Demographics
NPI:1023357142
Name:CITTA, CHRISTINA MARIE (MOT, OTR/L, DT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:CITTA
Suffix:
Gender:F
Credentials:MOT, OTR/L, DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 S GABLES BLVD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-6225
Mailing Address - Country:US
Mailing Address - Phone:630-708-8405
Mailing Address - Fax:630-480-6482
Practice Address - Street 1:1006 S GABLES BLVD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-6225
Practice Address - Country:US
Practice Address - Phone:630-708-8405
Practice Address - Fax:630-480-6482
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-08
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILCC05120513P222Q00000X
IL056012326225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist