Healthcare Provider Details

I. General information

NPI: 1801192000
Provider Name (Legal Business Name): CHRISTINA ANNA MARIE MCGILL CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2011
Last Update Date: 02/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3040 W SALT CREEK LN
ARLINGTON HEIGHTS IL
60005-1069
US

IV. Provider business mailing address

10329 CENTRAL PARK BLVD
HUNTLEY IL
60142-8187
US

V. Phone/Fax

Practice location:
  • Phone: 847-483-7043
  • Fax:
Mailing address:
  • Phone: 224-628-2393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number209007974
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: