MEDICARE: DR. CHRISTA S PESTKA MD

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	207Q00000X	Family Medicine Physician	036-107039	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CF3444	OTHER	IL	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356342331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTA S PESTKA MD

Provider Business Mailing Address
First Line	:	PO BOX 155
Second Line	:
City	:	CHRISTOPHER
State	:	IL
Zip	:	62822-0155
Country	:	US
Telephone Number	:	618-724-2401
Fax Number	:	618-724-4628

Provider Business Practice Location Address
First Line	:	14410 ROUTE 37
Second Line	:
City	:	JOHNSTON CITY
State	:	IL
Zip	:	62951-1427
Country	:	US
Telephone Number	:	618-983-6911
Fax Number	:	618-983-6913

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	02/10/2026

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