MEDICARE: CHRISTINE M EKIS OTR

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	174400000X	Specialist		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	022-32599	OTHER	IL	BCBS PPO

General Provider Information

NPI Number	:	1174693378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE M EKIS OTR

Provider Business Mailing Address
First Line	:	2777 FINLEY RD STE 27
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1037
Country	:	US
Telephone Number	:	630-424-9100
Fax Number	:	630-424-0565

Provider Business Practice Location Address
First Line	:	2777 FINLEY RD STE 27
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1037
Country	:	US
Telephone Number	:	630-424-9100
Fax Number	:	630-424-0565

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	07/08/2007

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