Provider Demographics
NPI:1962583856
Name:CHRISTIANSON, DUANE R (MA)
Entity type:Individual
Prefix:MR
First Name:DUANE
Middle Name:R
Last Name:CHRISTIANSON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:229 N MARION ST
Mailing Address - Street 2:APT. 2
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1909
Mailing Address - Country:US
Mailing Address - Phone:708-358-1511
Mailing Address - Fax:
Practice Address - Street 1:5TH AND ROOSEVELT RD
Practice Address - Street 2:BUILDING 113
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141-5000
Practice Address - Country:US
Practice Address - Phone:708-202-7966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255R0406XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistRehabilitation, Blind