Healthcare Provider Details

I. General information

NPI: 1366989501
Provider Name (Legal Business Name): CHRISTINA DAOUD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 10/28/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1723 HOWARD ST
EVANSTON IL
60202-3735
US

IV. Provider business mailing address

1342 NYODA PL
HIGHLAND PARK IL
60035-4513
US

V. Phone/Fax

Practice location:
  • Phone: 224-307-8550
  • Fax:
Mailing address:
  • Phone: 314-346-1479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209014895
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: