Individual provider Active NPI

Christin Page Friederich, WHNP-BC

  • Obstetrics & Gynecology Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1114300381
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
209012321 Issued in IL
Practice address
111 W Jackson Blvd Ste 1700
Chicago, IL 60604-3597
Phone
(888) 731-8994
Fax
(888) 732-8119
NPI assigned
Jul 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 209012321 IL Primary

Addresses

Primary practice location

111 W Jackson Blvd Ste 1700
Chicago, IL 60604-3597

Mailing address

111 W Jackson Blvd Ste 1700
Chicago, IL 60604-3597

Other practice location 1

1031 Bellevue Ave
Ste 400
Saint Louis, MO 63117-1818
Phone (314) 977-7455

Other practice location 2

2016 Vadalabene Dr Ste B
Maryville, IL 62062-6901
Phone (618) 288-2970

Other identifiers 2

IdentifierTypeStateIssuer
309014755OtherILCONTROLLED SUBSTANCE LICENSE NUMBER
209012321OtherILSTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210917001480 IL Practitioner - Nurse Practitioner 4183938087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Womens Care PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: christin.friederich.1@20824.direct.athenahealth.com
  • Direct secure messaging: christin.friederich.1@27069.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1114300381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W JACKSON BLVD STE 1700",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W JACKSON BLVD STE 1700",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043597",
            "telephone_number": "888-731-8994",
            "fax_number": "888-732-8119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1031 Bellevue Ave",
            "address_2": "Ste 400",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631171818",
            "country_code": "US",
            "telephone_number": "314-977-7455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2016 Vadalabene Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "620626901",
            "country_code": "US",
            "telephone_number": "618-288-2970",
            "fax_number": "618-288-3572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRIEDERICH",
        "first_name": "CHRISTIN",
        "middle_name": "PAGE",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-06",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "IL",
            "license": "209012321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE LICENSE NUMBER",
            "identifier": "309014755",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "209012321",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.