Individual
CHRISTOPHER NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1632 W 105TH ST, CHICAGO, IL 60643-2914
(773) 620-2507
Mailing address
1632 W 105TH ST, CHICAGO, IL 60643-2914
(773) 620-2507
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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