Provider Demographics
NPI:1285653717
Name:BAILEY, CHRISTOPHER J (DPM)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13520 S ROUTE 59 STE 104
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-5546
Mailing Address - Country:US
Mailing Address - Phone:815-230-2255
Mailing Address - Fax:815-230-4925
Practice Address - Street 1:13520 S ROUTE 59 STE 104
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-5546
Practice Address - Country:US
Practice Address - Phone:815-230-2255
Practice Address - Fax:815-230-4925
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-005166213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00389002OtherRAILROAD MEDICARE
IL0009932532OtherBLUE CROSS BLUE SHIELD
IL016005166Medicaid
IL0009932532OtherBLUE CROSS BLUE SHIELD
V01659Medicare UPIN
IL5537720001Medicare NSC