Basic Information
Provider Information
NPI: 1386246213
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TORIBIO
FirstName: KRISTOPHER
MiddleName:  
NamePrefix:  
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Credential:  
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Mailing Information
Address1: 2650 RIDGE AVE.
Address2: DEPT. OF ANESTHOSIOLOGY
City: EVANSTON
State: IL
PostalCode: 602011777
CountryCode: US
TelephoneNumber: 8475702760
FaxNumber: 8475702921
Practice Location
Address1: 2650 RIDGE AVE.
Address2: DEPT. OF ANESTHOSIOLOGY
City: EVANSTON
State: IL
PostalCode: 602011777
CountryCode: US
TelephoneNumber: 8475702760
FaxNumber: 8475702921
Other Information
ProviderEnumerationDate: 11/16/2020
LastUpdateDate: 12/03/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/01/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X041425604ILN Nursing Service ProvidersRegistered Nurse 
367500000X209022401ILY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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