Provider Demographics
NPI:1841958030
Name:SAHAKIAN, CHRISTON
Entity type:Individual
Prefix:
First Name:CHRISTON
Middle Name:
Last Name:SAHAKIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16927 MURPHY AVE
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-1240
Mailing Address - Country:US
Mailing Address - Phone:312-586-0003
Mailing Address - Fax:
Practice Address - Street 1:19900 GOVERNORS DR STE 300G
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1059
Practice Address - Country:US
Practice Address - Phone:312-586-0003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-04
Last Update Date:2021-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL291U00000X, 261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care