Individual
CHRISTINE M POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2403 HARNISH DR STE 101, ALGONQUIN, IL 60102
(224) 333-0730
Mailing address
2403 HARNISH DR, STE 101, ALGONQUIN, IL 60102-6803
(224) 520-0087
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-090598
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-090598
ILLINOIS LICENSE PHYSICIAN AND SURGEON
IL
Enumeration date
09/13/2006
Last updated
11/05/2018
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