Healthcare Provider Details

I. General information

NPI: 1104826361
Provider Name (Legal Business Name): CHRISTINA C. BARTZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 W 75TH ST STE 201
NAPERVILLE IL
60540-9336
US

IV. Provider business mailing address

1331 W 75TH ST STE 201
NAPERVILLE IL
60540-9336
US

V. Phone/Fax

Practice location:
  • Phone: 630-527-5000
  • Fax: 630-527-5440
Mailing address:
  • Phone: 630-527-5000
  • Fax: 630-527-5440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA02580
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number085-002685
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: