Christina Helen Repka, RSA

Individual provider Active NPI Surgical Physician Assistant · Manhattan, IL

NPI 1992911341 · NPPES record last updated Dec 30, 2013

Key facts

NPI
1992911341
Entity type
Individual (NPI type 1)
Primary specialty
Surgical Physician Assistant 363AS0400X
License
238.000096 (IL)
Practice address
24427 Arrowhead Dr
Manhattan, IL 60442-1452
Phone
(815) 278-2630
Fax
(815) 478-3167
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

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
238.000096ILMDSurgical Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 238.000096 IL Yes

Addresses

Primary practice location

24427 Arrowhead Dr
Manhattan, IL 60442-1452

Mailing address

24427 Arrowhead Dr
Manhattan, IL 60442-1452
Phone (815) 278-2630

Other identifiers

IdentifierTypeStateIssuer
9932724OtherILBCBS

Other providers in Manhattan, IL

All providers in Manhattan, IL · Surgical Physician Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.