Provider Demographics
NPI:1710293576
Name:BOLLIER, CHRISTINE (APN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:BOLLIER
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 1:7 BLANCHARD CIR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-2037
Mailing Address - Country:US
Mailing Address - Phone:630-668-5985
Mailing Address - Fax:630-580-7624
Practice Address - Street 1:7 BLANCHARD CIR
Practice Address - Street 2:SUITE 106
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-2037
Practice Address - Country:US
Practice Address - Phone:630-668-5985
Practice Address - Fax:630-580-7624
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209008248363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209008248Medicaid
IL215362Medicare PIN