| Mr Christopher John Differding, PA-C | |
|
600 E 1st St, Spring Valley, IL 61362-1512 | |
| (815) 664-2617 | |
| (815) 664-5204 |
| Full Name | Mr Christopher John Differding |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 15 Years |
| Location | 600 E 1st St, Spring Valley, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295002715 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 085.004245 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Osf Saint Elizabeth Medical Center | Peru, IL | Hospital |
| Osf Saint Clare Medical Center | Princeton, IL | Hospital |
| Osf Saint Paul Medical Center | Mendota, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Illinois Urologic Health Surgeons Sc | 0648209429 | 11 |
| T4 Medical Pllc | 0244769156 | 30 |
| Pai Participant 27, Pc | 2668872672 | 9 |
| Entity Name | Illinois Urologic Health Surgeons SC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316904964 PECOS PAC ID: 0648209429 Enrollment ID: O20050811000632 |
| Entity Name | Pai Participant 27, PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093398539 PECOS PAC ID: 2668872672 Enrollment ID: O20210614001032 |
| Entity Name | T4 Medical PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699546861 PECOS PAC ID: 0244769156 Enrollment ID: O20250514001709 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Christopher John Differding, PA-C 600 E 1st St, Spring Valley, IL 61362-1512 Ph: (815) 664-2617 | Mr Christopher John Differding, PA-C 600 E 1st St, Spring Valley, IL 61362-1512 Ph: (815) 664-2617 |
Tamara L Dunlap-workman, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 600 E 1st St, Spring Valley, IL 61362 Phone: 815-664-1600 |