Provider Demographics
NPI:1134708654
Name:LIMON, CHRISTOPHER (CSFA)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:
Last Name:LIMON
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6117 OLDCREEK LN
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-5337
Mailing Address - Country:US
Mailing Address - Phone:815-592-4178
Mailing Address - Fax:
Practice Address - Street 1:6117 OLDCREEK LN
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60431-5337
Practice Address - Country:US
Practice Address - Phone:815-592-4178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-02
Last Update Date:2024-07-07
Deactivation Date:2021-09-20
Deactivation Code:
Reactivation Date:2021-12-23
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty