Provider Demographics
NPI:1093730756
Name:CHRISTENSEN, JOHN G JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:CHRISTENSEN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:0S036 CHURCH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1203
Mailing Address - Country:US
Mailing Address - Phone:331-732-4600
Mailing Address - Fax:331-732-4602
Practice Address - Street 1:0S036 CHURCH ST STE 300
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1203
Practice Address - Country:US
Practice Address - Phone:331-732-4600
Practice Address - Fax:331-732-4602
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-04-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036076898208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL973112Medicare ID - Type Unspecified
ILC40685Medicare UPIN