Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 52562 | CO |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 036148074 | IL |
NPI | 1518942325 |
---|---|
Provider Name | Dr. Kristina Sinacori Walick |
First Address | Denver, CO 80237-3487 |
Second Address | Springfield, IL 62769-5504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 20/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
85386570 | (05) | CO |