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General NPI Number Information
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NPI Number | 1588928121
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Entity Type | Individual
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Provider Name | CHRISTINE RENAE WILKERSON D.C.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2012
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 1112 WILDER CT
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City | NAPERVILLE
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State | IL
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Zip | 60540-1307
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Country | US
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Telephone | 319-230-8502
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Fax |
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Provider Business Mailing Address
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Address Line | 1767 W OGDEN AVE STE 143
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City | NAPERVILLE
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State | IL
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Zip | 60540-5008
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Country | US
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Telephone | 303-558-9886
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1241
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License Number State | MS
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