Provider Demographics
NPI:1144809062
Name:FRANCISCO, CHRISTIAN PAUL T
Entity type:Individual
Prefix:
First Name:CHRISTIAN PAUL
Middle Name:T
Last Name:FRANCISCO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 FLEETWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-1811
Mailing Address - Country:US
Mailing Address - Phone:224-678-8222
Mailing Address - Fax:
Practice Address - Street 1:246 FLEETWOOD LN
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-1811
Practice Address - Country:US
Practice Address - Phone:224-678-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160008547225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant