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General NPI Number Information
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NPI Number | 1366084477
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Entity Type | Individual
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Provider Name | CHRISTINE WILSON APRN
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Gender | Female
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Dates
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Enumeration Date | 10/09/2019
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Last Update Date | 02/15/2026
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Provider Practice Location Address
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Address Line | 5225 OLD ORCHARD RD STE 50
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City | SKOKIE
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State | IL
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Zip | 60077-1027
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Country | US
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Telephone | 773-461-0220
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 RANDALL RD
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City | CRYSTAL LAKE
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State | IL
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Zip | 60014-8601
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Country | US
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Telephone | 815-356-0386
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 14673-33
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 277.004187
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 277.004187
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041440400
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License Number State | IL
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