Provider Demographics
NPI:1033206370
Name:MADARANG-STOFIK, CRISTINA RAYNE (MPT)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:RAYNE
Last Name:MADARANG-STOFIK
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:RAYNE
Other - Last Name:BALLET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:706 E BELL RD
Practice Address - Street 2:STE 121
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-6640
Practice Address - Country:US
Practice Address - Phone:602-795-8441
Practice Address - Fax:602-795-8447
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD200312251X0800X
DEJ100016022251X0800X
AZ11851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic