Individual provider Active NPI

Christine Maclean, NPC

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1740210004
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.016382 Issued in IL
Practice address
1725 W Harrison St Ste 117
Chicago, IL 60612-3848
Phone
(312) 942-6296
Fax
(312) 563-2201
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11756 TN
Family Nurse Practitioner 363LF0000X 209.016382 IL Primary

Addresses

Primary practice location

1725 W Harrison St Ste 117
Chicago, IL 60612-3848

Mailing address

1211 S Prairie Ave Apt 703
Chicago, IL 60605-3646
Phone (155) 047-1516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11756TNMDPhysical Therapist
209.016382ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allervie Health Professional Corporation PastSince Mar 15, 2021 Accepting new patients
Bruce L Wolf MD Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1740210004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 S PRAIRIE AVE APT 703",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053646",
            "telephone_number": "155-047-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 117",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123848",
            "telephone_number": "312-942-6296",
            "fax_number": "312-563-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACLEAN",
        "first_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "11756",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.016382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.