Provider Demographics
NPI:1326855172
Name:HODGES, CHRISTINA ROCHELLE
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ROCHELLE
Last Name:HODGES
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 1:8633 S NORMAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60620-2154
Mailing Address - Country:US
Mailing Address - Phone:312-961-0309
Mailing Address - Fax:
Practice Address - Street 1:235 E 103RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-2807
Practice Address - Country:US
Practice Address - Phone:872-327-8428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150114177104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker