Provider Demographics
NPI:1225275043
Name:FROST, CHRISTINE M (DVM)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:M
Last Name:FROST
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:M
Other - Last Name:HOLLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DVM
Mailing Address - Street 1:1248 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:LA SALLE
Mailing Address - State:IL
Mailing Address - Zip Code:61301-1545
Mailing Address - Country:US
Mailing Address - Phone:858-692-7249
Mailing Address - Fax:
Practice Address - Street 1:1248 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:LA SALLE
Practice Address - State:IL
Practice Address - Zip Code:61301-1545
Practice Address - Country:US
Practice Address - Phone:858-692-7249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL090.0099418174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian