Provider Demographics
NPI:1417390584
Name:HARVEY, CHRISTY MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:MARIE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTY
Other - Middle Name:MARIE
Other - Last Name:CUNNINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:40W330 LAFOX RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-6515
Mailing Address - Country:US
Mailing Address - Phone:630-584-9850
Mailing Address - Fax:630-513-5683
Practice Address - Street 1:40W330 LAFOX RD UNIT A
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-6515
Practice Address - Country:US
Practice Address - Phone:630-584-9850
Practice Address - Fax:630-513-5683
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018027901207W00000X
IAMD-44330207WX0107X
390200000X
IL036.141189207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program