1710022173 NPI number — PRINCETON FAMILY PHYSICIANS, S.C.

Table of content: CHRISTIANNE ELIZABETH STRICKLAND MD (NPI 1316100589)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710022173 NPI number — PRINCETON FAMILY PHYSICIANS, S.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRINCETON FAMILY PHYSICIANS, S.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710022173
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
530 PARK AVE E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PRINCETON
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
61356-3901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
815-875-4531
Provider Business Mailing Address Fax Number:
815-872-1535

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
530 PARK AVE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61356-3901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-875-4531
Provider Business Practice Location Address Fax Number:
815-872-1535
Provider Enumeration Date:
02/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ROBINSON
Authorized Official First Name:
MADELEINE
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
815-875-4531

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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