Provider Demographics
NPI:1710306725
Name:ADIQUE, CHRISTINE T (APNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:T
Last Name:ADIQUE
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-3430
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:262-551-4630
Practice Address - Street 1:825 S MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3218
Practice Address - Country:US
Practice Address - Phone:847-566-5200
Practice Address - Fax:847-566-5522
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8393-33363L00000X
IL209011448363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner