Provider Demographics
NPI:1851415608
Name:SEDLACK, CHRISTINE MARY (MED)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:MARY
Last Name:SEDLACK
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6151 N GLENWOOD AVE
Mailing Address - Street 2:#205
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-1832
Mailing Address - Country:US
Mailing Address - Phone:773-764-0951
Mailing Address - Fax:
Practice Address - Street 1:EAST 65TH STREET AT LAKE MICHIGAN
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-1395
Practice Address - Country:US
Practice Address - Phone:773-256-5796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner