Healthcare Provider Details

I. General information

NPI: 1295666766
Provider Name (Legal Business Name): CHRISTOPHER HARRELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11914 S ROUTE 59 STE 134
PLAINFIELD IL
60585-5110
US

IV. Provider business mailing address

143 HIGHPOINT DR
ROMEOVILLE IL
60446-3818
US

V. Phone/Fax

Practice location:
  • Phone: 815-469-1500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: