Provider Demographics
NPI:1912292780
Name:CIASCHINI, CHRIS (CMC)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:CIASCHINI
Suffix:
Gender:M
Credentials:CMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17027 ELLINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247
Mailing Address - Country:US
Mailing Address - Phone:210-364-7045
Mailing Address - Fax:
Practice Address - Street 1:401 S. GARY AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172
Practice Address - Country:US
Practice Address - Phone:630-957-5140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications