Provider Demographics
NPI:1356624035
Name:WANYANA, CHRISTINE (APN, MSN)
Entity type:Individual
Prefix:MISS
First Name:CHRISTINE
Middle Name:
Last Name:WANYANA
Suffix:
Gender:F
Credentials:APN, MSN
Other - Prefix:MISS
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:WANYANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP-BC, APN
Mailing Address - Street 1:3701 ALGONQUIN RD STE 1050
Mailing Address - Street 2:
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-3127
Mailing Address - Country:US
Mailing Address - Phone:847-305-3250
Mailing Address - Fax:815-806-1205
Practice Address - Street 1:3701 ALGONQUIN RD STE 1050
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-3127
Practice Address - Country:US
Practice Address - Phone:847-305-3250
Practice Address - Fax:815-806-1205
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277000743207RG0100X
IL377000725363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology