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General NPI Number Information
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NPI Number | 1942945332
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Entity Type | Individual
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Provider Name | CRISTIANE MEGUMI HAYATO UNSETH PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/01/2022
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 21481 N. RAND RD.
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City | KILDEER
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State | IL
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Zip | 60047-3061
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Country | US
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Telephone | 847-866-7846
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Fax |
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Provider Business Mailing Address
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Address Line | 21481 N RAND RD
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City | KILDEER
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State | IL
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Zip | 60047-3061
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Country | US
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Telephone | 847-881-5777
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085009181
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 085009181
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License Number State | IL
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