Provider Demographics
NPI:1306825856
Name:MIDKIFF, CHRISTINA L (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:MIDKIFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 VADALABENE DR
Mailing Address - Street 2:STE 200
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062-5631
Mailing Address - Country:US
Mailing Address - Phone:618-288-7408
Mailing Address - Fax:618-288-7418
Practice Address - Street 1:2023 VADALABENE DR
Practice Address - Street 2:STE 200
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-5631
Practice Address - Country:US
Practice Address - Phone:618-288-7408
Practice Address - Fax:618-288-7418
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036097885207VG0400X, 207VX0000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO115738OtherBLUE CROSS MISSOURI
IL205854306OtherTRICARE
IL387145OtherHEALTHLINK
IL6032205OtherBLUE CROSS OF ILLINOIS
IL036097885Medicaid
IL205854306OtherUNITED HEALTHCARE
IL214530OtherMEDICARE GROUP NUMBER
IL296498OtherGHP
IL205854306OtherCIGNA
IL253075OtherHARMONY
ILP00399401OtherRAILROAD MEDICARE
IL5861603OtherAETNA
IL205854306OtherTRICARE
IL5861603OtherAETNA