Healthcare Provider Details

I. General information

NPI: 1780255919
Provider Name (Legal Business Name): CHRISTINA ANNE ZOLPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 E CARL SANDBURG DR
GALESBURG IL
61401-1249
US

IV. Provider business mailing address

1120 N PRAIRIE ST
GALESBURG IL
61401-2758
US

V. Phone/Fax

Practice location:
  • Phone: 309-344-1151
  • Fax:
Mailing address:
  • Phone: 541-232-3247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: