MEDICARE: HEATHER M CHRISTAIN DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	DAPT001936	PA
2	2251X0800X	Orthopedic Physical Therapist	PT019460	PA
3	225100000X	Physical Therapist	070015852	IL

General Provider Information

NPI Number	:	1053518001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER M CHRISTAIN DPT

Provider Business Mailing Address
First Line	:	1781 SAINT JOHNS AVE
Second Line	:
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-3532
Country	:	US
Telephone Number	:	847-452-4066
Fax Number	:

Provider Business Practice Location Address
First Line	:	1781 SAINT JOHNS AVE
Second Line	:
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-3532
Country	:	US
Telephone Number	:	847-452-4066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	04/26/2022

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Directions to “ HEATHER M CHRISTAIN DPT” Practice Location

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