Provider Demographics
NPI:1013136662
Name:CHRISTIANSEN, CRAIG C (MT-BC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:C
Last Name:CHRISTIANSEN
Suffix:
Gender:M
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1942 SUFFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-4440
Mailing Address - Country:US
Mailing Address - Phone:708-345-6100
Mailing Address - Fax:
Practice Address - Street 1:1527 WESTCHESTER BLVD
Practice Address - Street 2:SUITE ONE SOUTH
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-3644
Practice Address - Country:US
Practice Address - Phone:708-345-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist