Provider Demographics
NPI:1255108858
Name:CHARTER, CATINA A
Entity type:Individual
Prefix:
First Name:CATINA
Middle Name:A
Last Name:CHARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25748 W SUNNYMERE DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-1461
Mailing Address - Country:US
Mailing Address - Phone:888-206-1757
Mailing Address - Fax:
Practice Address - Street 1:25748 W SUNNYMERE DR
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-1461
Practice Address - Country:US
Practice Address - Phone:888-206-1757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment