Individual
CHRISTINE R WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2000 LAKE AVE, WOODSTOCK, IL 60098-7401
(815) 337-7100
(815) 337-4790
Mailing address
2000 LAKE AVE, WOODSTOCK, IL 60098-7401
(815) 337-7100
(815) 337-4790
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085002234
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
371359450
FEDERAL EMPLOYER ID NUMBE
IL
01
—
665231
HEALTHLINK PROVIDER NUMBER
IL
01
—
CB3700
RAILROAD MEDICARE GROUP
IL
01
—
K06735
UMWA PROVIDER NUMBER
IL
01
—
P00121463
RAILROAD MEDICARE PROV #
IL
Enumeration date
06/24/2006
Last updated
02/19/2009
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