Healthcare Provider Details

I. General information

NPI: 1083562409
Provider Name (Legal Business Name): CHRISTINE MARIE NOLAN CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRIS MARIE NOLAN CADC

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 S CUYLER AVE
OAK PARK IL
60304-1503
US

IV. Provider business mailing address

516 S CUYLER AVE
OAK PARK IL
60304-1503
US

V. Phone/Fax

Practice location:
  • Phone: 708-955-4232
  • Fax:
Mailing address:
  • Phone: 708-955-4232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37309
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: