| NPI | 1871143453 |
|---|---|
| Former Legal Business Name | CHRISTINA H REPKA RSA |
| Entity Type | Organization |
| Authorized Contact | CHRISTINA H REPKA Owner 708-269-0669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2019-09-24 |