Provider Demographics
NPI:1720427735
Name:HOMAN, CHRISTOPHER (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:HOMAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2052 N CLEVELAND AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4505
Mailing Address - Country:US
Mailing Address - Phone:678-910-3664
Mailing Address - Fax:
Practice Address - Street 1:3522 GRAND ROCK CIR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-1649
Practice Address - Country:US
Practice Address - Phone:678-910-3664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV31019207P00000X
VA0101271019207P00000X
GA72763207P00000X
MO2016009029207P00000X
IL036140673207P00000X
TN54490207P00000X
NC2023-01033207P00000X
OH35.139579207P00000X
ARE-13095207P00000X
KY48716207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine