Provider Demographics
NPI:1659336899
Name:MUNN, CHRISTIANNE A (MS, CGC)
Entity Type:Individual
Prefix:
First Name:CHRISTIANNE
Middle Name:A
Last Name:MUNN
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:CHRISTI
Other - Middle Name:
Other - Last Name:MUNN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:201 E MADISON ST STE 328
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62702-5131
Mailing Address - Country:US
Mailing Address - Phone:217-545-6523
Mailing Address - Fax:
Practice Address - Street 1:400 N 9TH ST FL 3
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62702-5310
Practice Address - Country:US
Practice Address - Phone:217-545-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
93106170300000X
IL246.000044170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS