Healthcare Provider Details

I. General information

NPI: 1447735964
Provider Name (Legal Business Name): CHRISTINE HEALY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE KNIGHT PA-C

II. Dates (important events)

Enumeration Date: 10/01/2018
Last Update Date: 02/10/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 W 203RD ST STE 203
OLYMPIA FIELDS IL
60461-1190
US

IV. Provider business mailing address

2650 WARRENVILLE RD STE 280
DOWNERS GROVE IL
60515-2075
US

V. Phone/Fax

Practice location:
  • Phone: 708-747-4000
  • Fax: 708-503-3841
Mailing address:
  • Phone: 630-324-7900
  • Fax: 630-271-1813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: