Provider Demographics
NPI:1245348952
Name:OLSON, CHRISTINE ANN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ANN
Last Name:OLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 MILWAUKEE AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3587
Mailing Address - Country:US
Mailing Address - Phone:847-379-1415
Mailing Address - Fax:847-339-7707
Practice Address - Street 1:1020 MILWAUKEE AVE STE 208
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-3587
Practice Address - Country:US
Practice Address - Phone:847-379-1415
Practice Address - Fax:847-739-7077
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3360458812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL03619325Medicaid
01619325OtherBLUE CROSS
IL318601Medicare ID - Type Unspecified
01619325OtherBLUE CROSS