Healthcare Provider Details

I. General information

NPI: 1871393769
Provider Name (Legal Business Name): CHRISTINA OLIVIA GAINEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8350 S 86TH AVE APT 216
JUSTICE IL
60458-1814
US

IV. Provider business mailing address

8350 S 86TH AVE APT 216Q
JUSTICE IL
60458-1814
US

V. Phone/Fax

Practice location:
  • Phone: 215-987-8550
  • Fax:
Mailing address:
  • Phone: 215-987-8550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: