NPIMap

Individual provider Active NPI

Christina L Andre, DO

  • Family Medicine Physician
  • Sycamore, IL
National Provider Identifier
1831684729
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-158012 Issued in IL
Practice address
1850 Gateway Dr Ste 103
Sycamore, IL 60178-3192
Phone
(815) 758-8671
Fax
(815) 756-4892
NPI assigned
Jun 25, 2018
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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 036-158012 IL Primary

Addresses

Primary practice location

1850 Gateway Dr Ste 103
Sycamore, IL 60178-3192

Mailing address

1850 Gateway Dr Ste 103
Sycamore, IL 60178-3192
Phone (815) 758-8671

Other practice location 1

220 Springfield Dr Ste 210
Bloomingdale, IL 60108-2215
Phone (630) 213-7788

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address candre232493@direct.edward.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210831000911 IL Practitioner - Family Practice 0244636272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un Col of Osteopathic Medicine, New York, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1850 Gateway Dr
Suite 103
Sycamore, IL 60178-3192
Phone (815) 758-8671

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-158012ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Family Medicine CurrentSince Sep 3, 2024 Accepting new patients
Central Dupage Physician Group CurrentSince Sep 3, 2024 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

1850 Gateway Dr
Ste 103
Sycamore, IL 60178
Phone (815) 758-8671

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Interoperability endpoints

  • Direct secure messaging: candre232493@direct.edward.org

Organizations & group practices 2

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1831684729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 GATEWAY DR STE 103",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783192",
            "telephone_number": "815-758-8671",
            "fax_number": "815-756-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 GATEWAY DR STE 103",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783192",
            "telephone_number": "815-758-8671",
            "fax_number": "815-756-4892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Springfield Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Bloomingdale",
            "state": "IL",
            "postal_code": "601082215",
            "country_code": "US",
            "telephone_number": "630-213-7788",
            "fax_number": "630-289-8450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDRE",
        "first_name": "CHRISTINA",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-158012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "candre232493@direct.edward.org",
            "affiliation": "N",
            "address_1": "220 Springfield Dr Ste 210",
            "city": "Bloomingdale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601082215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

Verify at the official NPI Registry.