Provider Demographics
NPI:1457868085
Name:VARGAS, CHRISTINA (LSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 S OLD RAND RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-3127
Mailing Address - Country:US
Mailing Address - Phone:312-420-9012
Mailing Address - Fax:
Practice Address - Street 1:21925 W FIELD PKWY STE 215
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:IL
Practice Address - Zip Code:60010-7278
Practice Address - Country:US
Practice Address - Phone:312-420-9012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-04
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health