Provider Demographics
NPI:1679904403
Name:GERNHOFER, CHRISTY MCNEELA (APN)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:MCNEELA
Last Name:GERNHOFER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8130 N OSCEOLA AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-2948
Mailing Address - Country:US
Mailing Address - Phone:773-616-7649
Mailing Address - Fax:
Practice Address - Street 1:9201 WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-2102
Practice Address - Country:US
Practice Address - Phone:847-626-1600
Practice Address - Fax:847-626-1650
Is Sole Proprietor?:No
Enumeration Date:2013-12-04
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277001288363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner