Individual
DR. PETER AUSTIN CHRISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070011972
IL
2251X0800X
Orthopedic Physical Therapist
Primary
PT010325
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08220357
BCBS GRP#
IL
01
—
900068033
TAX-ID#
IL
01
—
K28891
MEDICARE #
IL
Enumeration date
03/11/2006
Last updated
11/06/2024
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