Individual
CHRISTINE L THARENOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2321 N WISCONSIN AVE, PEORIA, IL 61603-5613
(309) 680-7600
(309) 681-4681
Mailing address
2214 N UNIVERSITY ST, PEORIA, IL 61604-3221
(309) 680-7600
(309) 681-8443
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD113191
MO
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
201201008
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036140703
—
IL
Enumeration date
05/16/2006
Last updated
07/21/2022
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