Healthcare Provider Details

I. General information

NPI: 1487092599
Provider Name (Legal Business Name): CHRISTOPHER BAPTIST D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2013
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 N WEST ST
OLNEY IL
62450-1160
US

IV. Provider business mailing address

363 N WEST ST
OLNEY IL
62450-1160
US

V. Phone/Fax

Practice location:
  • Phone: 618-392-9400
  • Fax: 618-395-2131
Mailing address:
  • Phone: 618-392-9400
  • Fax: 618-395-2131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number16006041
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: