Individual provider Active NPI

Christina E Vandenbosch, M.D.

  • Family Medicine Physician
  • Hinsdale, IL
National Provider Identifier
1225144306
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
11 Salt Creek LN Ste 125
Hinsdale, IL 60521-2902
Phone
(630) 655-1177
Fax
(630) 655-1192
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

11 Salt Creek LN Ste 125
Hinsdale, IL 60521-2902

Mailing address

11 Salt Creek LN Ste 125
Hinsdale, IL 60521-2902
Phone (630) 655-1177

Other identifiers 1

IdentifierTypeStateIssuer
2232216OtherILBC/BS OF IL PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-102209ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Burr Ridge Family Practice , LTD. Family Medicine Past Accepting new patients

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1225144306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SALT CREEK LN STE 125",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605212902",
            "telephone_number": "630-655-1177",
            "fax_number": "630-655-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SALT CREEK LN STE 125",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605212902",
            "telephone_number": "630-655-1177",
            "fax_number": "630-655-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBOSCH",
        "first_name": "CHRISTINA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF IL PROVIDER #",
            "identifier": "2232216",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.