NPIMap

Organization Active NPI

Christina Dolack LLC

  • Internal Medicine Physician
  • Seneca, IL
National Provider Identifier
1023337482
Registry record updated May 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036107487 Issued in IL
Legal business name
CHRISTINA DOLACK LLC
Practice address
271 N Main St
Seneca, IL 61360-9323
Phone
(815) 357-8511
Fax
(815) 357-1238
NPI assigned
May 25, 2010
Last updated
May 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christina N Dolack, DO
Title
Owner
Phone
(815) 357-8511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 036107487 IL Primary

Addresses

Primary practice location

271 N Main St
Seneca, IL 61360-9323

Mailing address

271 N Main St
Seneca, IL 61360-9323
Phone (815) 357-8511

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274745600000",
    "number": "1023337482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 N MAIN ST",
            "city": "SENECA",
            "state": "IL",
            "postal_code": "613609323",
            "telephone_number": "815-357-8511",
            "fax_number": "815-357-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 N MAIN ST",
            "city": "SENECA",
            "state": "IL",
            "postal_code": "613609323",
            "telephone_number": "815-357-8511",
            "fax_number": "815-357-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTINA DOLACK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-25",
        "last_updated": "2010-05-25",
        "status": "A",
        "authorized_official_last_name": "DOLACK",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-357-8511",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036107487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.