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Individual
JOSEPH M CHRISTENSEN
Active
Individual
JOSEPH M CHRISTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036095913
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222075
BLUE CROSS GROUP NUMBER
IL
05
—
036095913
—
IL
01
—
363149833
TAX IDENTIFICATION NUMBER
IL
01
—
3631498336019001
CDPG HFS PAYEE ID
IL
01
—
487450010
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
07/24/2006
Last updated
04/02/2013
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