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General NPI Number Information
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NPI Number | 1053637116
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Entity Type | Organization
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Legal Business Name | DR.CHRISTOPHER PAPA, LLC
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 04/14/2010
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Provider Practice Location Address
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Address Line | 2825 GLACIER WAY UNIT E
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City | WAUCONDA
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State | IL
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Zip | 60084-5080
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Country | US
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Telephone | 224-475-6998
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Fax |
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Provider Business Mailing Address
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Address Line | 2825 GLACIER WAY UNIT E
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City | WAUCONDA
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State | IL
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Zip | 60084-5080
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Country | US
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Telephone | 224-475-6998
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER M PAPA
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Credential | DO
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Telephone | 224-475-6998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 036112791
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License Number State | IL
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