Provider Demographics
NPI:1194972646
Name:FOHS, CHRISTINE E (MS)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:E
Last Name:FOHS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 DEMPSTER ST
Mailing Address - Street 2:SUITE 510
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-8412
Mailing Address - Country:US
Mailing Address - Phone:847-824-1235
Mailing Address - Fax:847-824-2386
Practice Address - Street 1:2604 DEMPSTER ST
Practice Address - Street 2:SUITE 510
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-8412
Practice Address - Country:US
Practice Address - Phone:847-824-1235
Practice Address - Fax:847-824-2386
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180003187101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional