Individual
CHRISTOPHER M NORTHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
360 STATION DR, CRYSTAL LAKE, IL 60014-7978
(815) 356-2330
(815) 477-9826
Mailing address
360 STATION DR, CRYSTAL LAKE, IL 60012
(815) 338-6600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1898-023
WI
363A00000X
Physician Assistant
Primary
1898-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43025400
—
WI
Enumeration date
10/13/2006
Last updated
02/02/2018
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