Provider Demographics
NPI:1063432532
Name:HALLIDAY, CHRISTOPHER J
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:HALLIDAY
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 1:1225 W MORSE AVE
Mailing Address - Street 2:#401
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-5798
Mailing Address - Country:US
Mailing Address - Phone:773-931-8310
Mailing Address - Fax:
Practice Address - Street 1:3505 N. ASHLAND AVE.
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657
Practice Address - Country:US
Practice Address - Phone:773-248-4229
Practice Address - Fax:773-248-4222
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2008-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009504111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL35-2311941OtherFEIN
IL7859515OtherAETNA