Healthcare Provider Details

I. General information

NPI: 1427541986
Provider Name (Legal Business Name): CHRISTOPHER JAMES HARTER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2018
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 N YORK RD STE 11
HINSDALE IL
60521
US

IV. Provider business mailing address

777 N YORK RD STE 11
HINSDALE IL
60521-3561
US

V. Phone/Fax

Practice location:
  • Phone: 630-819-8384
  • Fax: 708-469-4100
Mailing address:
  • Phone: 306-819-8384
  • Fax: 630-468-0605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.023598
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: