Individual provider Active NPI

Christine Erickson, MD

  • Internal Medicine Physician
  • Hines, IL
National Provider Identifier
1336183912
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-103190 Issued in IL
Practice address
5000 5TH Avenue
Hines, IL 60141-5000
Phone
(708) 202-3800
Fax
(708) 202-2195
NPI assigned
Jun 15, 2006
Last updated
May 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-103190 IL Primary

Addresses

Primary practice location

5000 5TH Avenue
Hines, IL 60141-5000

Mailing address

5000 5TH Avenue
Hines, IL 60141-5000
Phone (708) 202-3800

Other names 1

  • Dr. Christine Erickson Professional name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120622000079 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9537337654

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-103190ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1336183912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 5TH AVENUE",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601415000",
            "telephone_number": "708-202-3800",
            "fax_number": "708-202-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 5TH AVENUE",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601415000",
            "telephone_number": "708-202-3800",
            "fax_number": "708-202-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-103190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "ERICKSON",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Hines, IL

Sources for this page

Verify at the official NPI Registry.