Healthcare Provider Details

I. General information

NPI: 1790140820
Provider Name (Legal Business Name): CHRISTINA FRANCISCO MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2015
Last Update Date: 12/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6417 W IRVING PARK RD
CHICAGO IL
60634-2437
US

IV. Provider business mailing address

804 W GEORGE ST G
CHICAGO IL
60657-5127
US

V. Phone/Fax

Practice location:
  • Phone: 773-777-7112
  • Fax:
Mailing address:
  • Phone: 973-600-1098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: