Provider Demographics
NPI:1972652170
Name:CHRISTIANSEN, TERRI F (PHD)
Entity type:Individual
Prefix:DR
First Name:TERRI
Middle Name:F
Last Name:CHRISTIANSEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10623 RACHEL LN
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-1375
Mailing Address - Country:US
Mailing Address - Phone:708-942-7479
Mailing Address - Fax:708-221-6126
Practice Address - Street 1:10729 163RD PL
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-8861
Practice Address - Country:US
Practice Address - Phone:708-942-7479
Practice Address - Fax:708-221-6126
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-005624103TC0700X
IL071005624103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1972652170OtherNIP PERSONAL
IL1619098282OtherNPI ORGANIZATION
IL1619098282OtherNPI ORGANIZATION