Healthcare Provider Details

I. General information

NPI: 1891979399
Provider Name (Legal Business Name): CHRISTENSEN & SONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2007
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11225 FRONT STREET SUITE 11
MOKENA IL
60448
US

IV. Provider business mailing address

3314 TIMBERS EDGE CIRCLE
JOLIET IL
60431
US

V. Phone/Fax

Practice location:
  • Phone: 773-758-9242
  • Fax:
Mailing address:
  • Phone: 773-758-9242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149-012322
License Number StateIL

VIII. Authorized Official

Name: ERIK CHRISTENSEN
Title or Position: MANAGER/PRES
Credential: LSW
Phone: 773-758-3364