Provider Demographics
NPI:1285845149
Name:AMIDEI, CHRISTINA MARIE (RN, APRN, CNS)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:AMIDEI
Suffix:
Gender:F
Credentials:RN, APRN, CNS
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:675 N SAINT CLAIR ST STE 20-250
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5928
Mailing Address - Country:US
Mailing Address - Phone:312-695-8143
Mailing Address - Fax:312-695-4075
Practice Address - Street 1:675 N SAINT CLAIR ST STE 20-250
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5928
Practice Address - Country:US
Practice Address - Phone:312-695-8143
Practice Address - Fax:312-695-4075
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209003259364SN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SN0800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistNeuroscience
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK08062Medicare UPIN
ILQ19645Medicare ID - Type Unspecified