DEBRA RENAE NICKOLI


Address: 401 E Ontario St Apt 4003, Chicago, IL 60611-4443
Phone: 6146686237

DEBRA RENAE NICKOLI (NPI# 1184989964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1184989964
Entity Type Individual
Full Name DEBRA RENAE NICKOLI
Other Name DEBRA RENAE NICKOLI
Credential PT
Practice Address 401 E Ontario St Apt 4003
Chicago
IL 60611-4443
Practice Telephone 6146686237
Mailing Telephone 6146686237
Enumeration Date 2012-07-09
Last Update Date 2012-07-09
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2251P0200X Physical Therapist
Specialization: Pediatrics
070018390 IL Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Office Location

Street Address 401 E ONTARIO ST APT 4003
City CHICAGO
State IL
Zip Code 60611-4443

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Taxonomy Information

Taxonomy Code 2251P0200X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Physical Therapist
Specialization Pediatrics

Taxonomy Definition

Definition to come...

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Competitor

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City CHICAGO
Zip Code 60611

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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