Basic Information
| Provider Information | |||||||||
| NPI: | 1992923288 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BISHOF | ||||||||
| FirstName: | CHRISTINE | ||||||||
| MiddleName: | PABIN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12935 GREGORY ST | ||||||||
| Address2: | |||||||||
| City: | BLUE ISLAND | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604062428 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 12935 GREGORY ST | ||||||||
| Address2: | |||||||||
| City: | BLUE ISLAND | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604062428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7085972000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2007 | ||||||||
| LastUpdateDate: | 06/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 01073747A | IN | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 036.118899 | IL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 4301099003 | MI | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.