Provider Demographics
NPI:1053523761
Name:DIMITROPOULOS, CHRISTINA L (NP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:DIMITROPOULOS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 CASS AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-5013
Mailing Address - Country:US
Mailing Address - Phone:630-920-1900
Mailing Address - Fax:
Practice Address - Street 1:8110 S CASS AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-5013
Practice Address - Country:US
Practice Address - Phone:312-942-6163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-006535363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner