Provider Demographics
NPI:1417919333
Name:EDGINTON, CHRISTOPHER KIRKWOOD (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:KIRKWOOD
Last Name:EDGINTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 S MICHIGAN AVE STE 1265
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-6200
Mailing Address - Country:US
Mailing Address - Phone:312-939-4121
Mailing Address - Fax:312-939-8011
Practice Address - Street 1:122 S MICHIGAN AVE STE 1265
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-6200
Practice Address - Country:US
Practice Address - Phone:312-939-4121
Practice Address - Fax:312-939-8011
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038009577Medicaid
ILK06818Medicare ID - Type Unspecified