Basic Information
| Provider Information | |||||||||
| NPI: | 1548987530 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | TAYLOR | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | CHASE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2600 COMPASS RD | ||||||||
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| City: | GLENVIEW | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600268001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8777873430 | ||||||||
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| Practice Location | |||||||||
| Address1: | 225 WHITE ST | ||||||||
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| City: | JACKSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285466351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103537222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2022 | ||||||||
| LastUpdateDate: | 10/20/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | P18431 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.