Individual
PHILLIP DECHRISTOPHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
2160 S FIRST AVE, EMS BLDG., RM. 2209, MAYWOOD, IL 60153
(708) 216-3250
(708) 216-2620
Mailing address
2160 S FIRST AVE, EMS BLDG., RM. 2209, MAYWOOD, IL 60153
(708) 216-3250
(708) 216-2620
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
Primary
36068429
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36068429
—
IL
01
—
K16217
MEDICARE
IL
Enumeration date
01/17/2006
Last updated
01/28/2022
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