Healthcare Provider Details

I. General information

NPI: 1497408330
Provider Name (Legal Business Name): CHRISTINE JOY M LOCQUIAO APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E SUPERIOR ST STE 5-2322
CHICAGO IL
60611-2914
US

IV. Provider business mailing address

250 E SUPERIOR ST STE 5-2322
CHICAGO IL
60611-2914
US

V. Phone/Fax

Practice location:
  • Phone: 312-926-3411
  • Fax: 312-926-8430
Mailing address:
  • Phone: 312-926-3411
  • Fax: 312-926-8430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209022895
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number209022895
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: