Provider Demographics
NPI:1780255919
Name:ZOLPER, CHRISTINA ANNE
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ANNE
Last Name:ZOLPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 N PRAIRIE ST
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-2758
Mailing Address - Country:US
Mailing Address - Phone:541-232-3247
Mailing Address - Fax:
Practice Address - Street 1:275 E CARL SANDBURG DR
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-1249
Practice Address - Country:US
Practice Address - Phone:309-344-1151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility