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General NPI Number Information
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NPI Number | 1417390584
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Entity Type | Individual
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Provider Name | CHRISTY MARIE HARVEY MD
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Gender | Female
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Dates
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Enumeration Date | 04/09/2013
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 40W330 LAFOX RD UNIT A
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City | ST CHARLES
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State | IL
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Zip | 60175-6515
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Country | US
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Telephone | 630-584-9850
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Fax | 630-513-5683
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Provider Business Mailing Address
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Address Line | 40W330 LAFOX RD UNIT A
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City | ST CHARLES
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State | IL
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Zip | 60175-6515
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Country | US
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Telephone | 630-584-9850
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Fax | 630-513-5683
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 2018027901
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | MD-44330
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 036.141189
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License Number State | IL
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