Provider Demographics
NPI:1891715967
Name:CUNNINGHAM, CHRISTINE L (ATC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:L
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1739 IVY LN
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-5837
Mailing Address - Country:US
Mailing Address - Phone:847-733-9066
Mailing Address - Fax:
Practice Address - Street 1:1739 IVY LN
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-5837
Practice Address - Country:US
Practice Address - Phone:847-733-9066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL960004142255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer