Provider Demographics
NPI:1245683473
Name:ROSARIO, CHRISTIAN ABRAHAM (DC)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:ABRAHAM
Last Name:ROSARIO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10151 SCHILLER BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60131-2478
Mailing Address - Country:US
Mailing Address - Phone:773-787-7795
Mailing Address - Fax:
Practice Address - Street 1:2960 N PULASKI RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-5422
Practice Address - Country:US
Practice Address - Phone:773-787-7795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-23
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor