MEDICARE: DR. CHRISTINA PASCALE DMD

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
1	1223G0001X	General Practice Dentistry	11087	KY
2	1223G0001X	General Practice Dentistry	019.034219	IL

General Provider Information

NPI Number	:	1619660297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA PASCALE DMD

Provider Business Mailing Address
First Line	:	2414 N MOZART ST APT G
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-2614
Country	:	US
Telephone Number	:	973-650-2844
Fax Number	:

Provider Business Practice Location Address
First Line	:	5643 N FAIRFIELD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-4816
Country	:	US
Telephone Number	:	773-271-5200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2023
Last Update Date	:	04/01/2024

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