Provider Demographics
NPI:1841301645
Name:FERGUSON, CHRISTINA M (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 LAKEVIEW PARKWAY
Mailing Address - Street 2:SUITE 195
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60661
Mailing Address - Country:US
Mailing Address - Phone:847-247-7200
Mailing Address - Fax:847-247-4340
Practice Address - Street 1:935 LAKEVIEW PARKWAY
Practice Address - Street 2:SUITE 195
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60661
Practice Address - Country:US
Practice Address - Phone:847-247-7200
Practice Address - Fax:847-247-4340
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0034941885OtherBCBS
Q41253Medicare UPIN
ILK16615Medicare ID - Type Unspecified