Individual
DR. CHRISTOPHER J DEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1611 W HARRISON ST, STE 400, CHICAGO, IL 60612-3841
(312) 243-4244
(312) 942-1517
Mailing address
1 WESTBROOK CORPORATE CTR, #240, WESTCHESTER, IL 60154-5701
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
036080160
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1633878
BCBS
IL
01
—
207067
MEDICARE PTAN LOCALITY 16
IL
01
—
207073
MEDICARE PTAN LOCALITY 15
IL
01
—
5309059
AETNA
—
Enumeration date
07/10/2006
Last updated
09/18/2018
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