Healthcare Provider Details

I. General information

NPI: 1023095155
Provider Name (Legal Business Name): CHRISTINE MARIE MARIAN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1227 RITTER ST
NORTH AURORA IL
60542-8922
US

IV. Provider business mailing address

1227 RITTER ST
NORTH AURORA IL
60542-8922
US

V. Phone/Fax

Practice location:
  • Phone: 708-815-0717
  • Fax:
Mailing address:
  • Phone: 708-815-0717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038-009452
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: