Provider Demographics
NPI:1851463780
Name:CHRIST, NANCY ALEXANDER (OD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ALEXANDER
Last Name:CHRIST
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1871 S RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4434
Mailing Address - Country:US
Mailing Address - Phone:630-377-2020
Mailing Address - Fax:630-584-2052
Practice Address - Street 1:1871 S RANDALL RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4434
Practice Address - Country:US
Practice Address - Phone:630-377-2020
Practice Address - Fax:630-584-2052
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-008657152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1851463870OtherNPI
IL1851463870OtherNPI
ILU56653Medicare UPIN