Provider Demographics
NPI:1477737138
Name:GIRGIS, CHRISTINA MORRIS (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MORRIS
Last Name:GIRGIS
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 1:6502 JOLIET RD
Mailing Address - Street 2:
Mailing Address - City:COUNTRYSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-4682
Mailing Address - Country:US
Mailing Address - Phone:708-215-8400
Mailing Address - Fax:708-215-8410
Practice Address - Street 1:6502 JOLIET RD
Practice Address - Street 2:
Practice Address - City:COUNTRYSIDE
Practice Address - State:IL
Practice Address - Zip Code:60525-4682
Practice Address - Country:US
Practice Address - Phone:708-215-8400
Practice Address - Fax:708-215-8410
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361197782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036119778OtherSTATE LICENSE