Provider Demographics
NPI:1336183912
Name:ERICKSON, CHRISTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:ERICKSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5000 5TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:HINES
Mailing Address - State:IL
Mailing Address - Zip Code:60141-5000
Mailing Address - Country:US
Mailing Address - Phone:708-202-3800
Mailing Address - Fax:708-202-2195
Practice Address - Street 1:5000 5TH AVENUE
Practice Address - Street 2:
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141-5000
Practice Address - Country:US
Practice Address - Phone:708-202-3800
Practice Address - Fax:708-202-2195
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-103190207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine