Provider Demographics
NPI:1508583725
Name:FRISONE, KRISTINE MICHELLE
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:MICHELLE
Last Name:FRISONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 CATAMARAN CIR
Mailing Address - Street 2:
Mailing Address - City:PINGREE GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60140-1303
Mailing Address - Country:US
Mailing Address - Phone:425-358-0724
Mailing Address - Fax:
Practice Address - Street 1:820 E TERRA COTTA AVE STE 116
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-3650
Practice Address - Country:US
Practice Address - Phone:224-256-2607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health