Healthcare Provider Details

I. General information

NPI: 1053518001
Provider Name (Legal Business Name): HEATHER M CHRISTAIN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER M RALSTON DPT

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 DODGE AVE
EVANSTON IL
60201-4032
US

IV. Provider business mailing address

1320 DODGE AVE
EVANSTON IL
60201-4032
US

V. Phone/Fax

Practice location:
  • Phone: 847-220-8046
  • Fax: 833-672-3417
Mailing address:
  • Phone: 847-220-8046
  • Fax: 833-672-3417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070015852
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT019460
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberDAPT001936
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: