MEDICARE: CHRISTINA DAOUD FNP

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	363LF0000X	Family Nurse Practitioner	209014895	IL

General Provider Information

NPI Number	:	1366989501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA DAOUD FNP

Provider Business Mailing Address
First Line	:	1342 NYODA PL
Second Line	:
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-4513
Country	:	US
Telephone Number	:	314-346-1479
Fax Number	:

Provider Business Practice Location Address
First Line	:	1723 HOWARD ST
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60202-3735
Country	:	US
Telephone Number	:	224-307-8550
Fax Number	:

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

Provider Enumeration Date	:	01/26/2017
Last Update Date	:	10/28/2022

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