Provider Demographics
NPI:1649970286
Name:TOBIAS, CRISTINA (PT, DPT)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:TOBIAS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 N NAPER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-2622
Mailing Address - Country:US
Mailing Address - Phone:773-899-3924
Mailing Address - Fax:
Practice Address - Street 1:2521 BOONE RD SE STE 100
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-9391
Practice Address - Country:US
Practice Address - Phone:503-585-5131
Practice Address - Fax:503-585-4065
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR65269225100000X
CA303768225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist