Individual
DR. CHRISTOPHER ROBERT WAKID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2274
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2274
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
125.065164
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125.065164
ILLINOIS TEMPORARY PHYSICIAN LICENSE NUMBER
IL
Enumeration date
06/24/2014
Last updated
06/24/2014
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