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NPI Code Detail

MEDICARE: CHRISTOPHER JORDAN TEAGUE

MEDICARE: CHRISTOPHER JORDAN TEAGUE
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
1225200000XPhysical Therapy Assistant160.010339IL

General Provider Information

NPI Number : 1598628208
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER JORDAN TEAGUE
Provider Business Mailing Address
First Line : 1644 E 53RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60615-4489
Country : US
Telephone Number : 773-241-6450
Fax Number : 773-241-6501
Provider Business Practice Location Address
First Line : 1644 E 53RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60615-4489
Country : US
Telephone Number : 773-241-6450
Fax Number : 773-241-6501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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Directions to “ CHRISTOPHER JORDAN TEAGUE ” Practice Location

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