Basic Information
| Provider Information | |||||||||
| NPI: | 1992738264 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GERAGHTY | ||||||||
| FirstName: | CHRISTINE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 220 COMPASS POINT DR | ||||||||
| Address2: | |||||||||
| City: | SAINT CHARLES | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633014405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6369474480 | ||||||||
| FaxNumber: | 6369479860 | ||||||||
| Practice Location | |||||||||
| Address1: | 1475 KISKER RD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | SAINT CHARLES | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633048781 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6364987800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 2001007762 | MO | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | P00168240 | 01 | RAILROAD MEDICARE NUMBER | OTHER |