Provider Demographics
NPI:1073766267
Name:PALICKE, CHRISTINE MAUREEN (APN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MAUREEN
Last Name:PALICKE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 W 203RD ST STE 203
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1190
Mailing Address - Country:US
Mailing Address - Phone:708-747-4000
Mailing Address - Fax:708-503-3841
Practice Address - Street 1:3800 W 203RD ST STE 203
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1190
Practice Address - Country:US
Practice Address - Phone:708-747-4000
Practice Address - Fax:708-503-3841
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28106899A163WG0000X
IL209007612363LF0000X
IN71002988A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice