James Mark Christian, M. DIV., L.C.P.C.

Individual provider Active NPI Professional Counselor · Oak Forest, IL

NPI 1508970153 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1508970153
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
Practice address
6006 W. 159 Street
Oak Forest, IL 60452
Phone
(708) 535-7320
Fax
(708) 535-7571
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
180-002426ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Genesis Therapy Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X IL Yes

Addresses

Primary practice location

6006 W. 159 Street
Oak Forest, IL 60452

Mailing address

9154 S Damen Ave
Chicago, IL 60620-5508

Other providers in Oak Forest, IL

All providers in Oak Forest, IL · Professional Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.