Healthcare Provider Details

I. General information

NPI: 1427084532
Provider Name (Legal Business Name): CHRISTOPHER JON CALVERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 W COLLEGE DR
PALOS HEIGHTS IL
60463-1001
US

IV. Provider business mailing address

11827 OREGON TRL
ORLAND PARK IL
60467-1223
US

V. Phone/Fax

Practice location:
  • Phone: 708-448-2438
  • Fax:
Mailing address:
  • Phone: 708-460-7626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: