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NPI Code Detail

MEDICARE: CHRISTIE CLINIC, PLLC

MEDICARE: CHRISTIE CLINIC, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1295328896
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHRISTIE CLINIC, PLLC
Provider Business Mailing Address
First Line : 101 W UNIVERSITY AVE
Second Line :
City : CHAMPAIGN
State : IL
Zip : 61820-3981
Country : US
Telephone Number : 217-366-8107
Fax Number :
Provider Business Practice Location Address
First Line : 3101 FIELDS SOUTH DR
Second Line :
City : CHAMPAIGN
State : IL
Zip : 61822-3743
Country : US
Telephone Number : 217-366-4000
Fax Number :
Authorized Official
Title or Position : CMO
Name : CANDACE D MCGREGOR
Credential : MD
Telephone Number : 217-366-1255
Provider Enumeration Date : 02/15/2021
Last Update Date : 12/17/2025

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Directions to “CHRISTIE CLINIC, PLLC ” Practice Location

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