Provider Demographics
NPI:1831684729
Name:ANDRE, CHRISTINA L (DO)
Entity type:Individual
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First Name:CHRISTINA
Middle Name:L
Last Name:ANDRE
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Gender:F
Credentials:DO
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Mailing Address - Street 1:1850 GATEWAY DR STE 103
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-3192
Mailing Address - Country:US
Mailing Address - Phone:815-758-8671
Mailing Address - Fax:815-756-4892
Practice Address - Street 1:1850 GATEWAY DR STE 103
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-3192
Practice Address - Country:US
Practice Address - Phone:815-758-8671
Practice Address - Fax:815-756-4892
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2024-11-14
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Provider Licenses
StateLicense IDTaxonomies
IL036-158012207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL125.072714OtherSTATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION