LISA NICKLAS (NPI# 1548552078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548552078 |
| Entity Type | Individual |
| Full Name | LISA NICKLAS |
| Other Name | LISA FICCO |
| Practice Address |
1790 Nations Dr Ste 116 Gurnee IL 60031-9175 |
| Practice Telephone | 8472456567 |
| Mailing Telephone | 8472456567 |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180.007737 | IL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1021 N Mulford Rd, Suite 1, Rockford, IL 611073877 | 8153999700 |
| Street Address |
1790 NATIONS DR STE 116 |
| City | GURNEE |
| State | IL |
| Zip Code | 60031-9175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821648189 | Lindsay G. Williams | Counselor | 1790 Nations Dr Ste 116, Gurnee, IL 60031-9175 | 2019-09-18 |
| 1023529054 | Indira Deciret Vences | Social Worker | 1790 Nations Dr Ste 116, Gurnee, IL 60031-9175 | 2017-10-17 |
| 1093247694 | Ana Alicia Maroon | Counselor | 1790 Nations Dr Ste 116, Gurnee, IL 60031-9175 | 2017-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881174720 | Rockelle Waggoner | Behavioral Analyst | 489 Tanglewood Dr, Gurnee, IL 60031 | 2018-08-20 |
| 1316434376 | Lake County Internal Medicine Assoc LLC | Non-Pharmacy Dispensing Site | 15 Tower Ct., Ste 190, Gurnee, IL 60031 | 2018-04-16 |
| 1588163364 | Advanced Endodontics, PC | Dentist | 103 S. Greenleaf Street, Suite K, Gurnee, IL 60031 | 2018-02-07 |
| 1578081550 | Northshore Medical Consultants, Ltd | Family Medicine | 1425 Hunt Club Rd. #302, Gurnee, IL 60031 | 2017-08-30 |
| 1336678739 | Sarah Beth Fugelseth | Nurse Practitioner | 1445 N Hunt Club Rd Ste 304, Gurnee, IL 60031 | 2017-06-08 |
| 1174079867 | Lifecarepros, LLC | In Home Supportive Care | 223 North Route 21, Gurnee, IL 60031 | 2016-09-01 |
| 1740733195 | Ryan Lee Winslow | Chiropractor | 6021 Washington St, Unit B, Gurnee, IL 60031 | 2016-08-02 |
| 1891129599 | Smart Scan Mri, LLC | Clinic/Center | 350 S. Greenleaf, Suite 401, Gurnee, IL 60031 | 2013-08-29 |
| 1568720076 | Yudelca Romano | Genetic Counselor, MS | 1125 Tri State Parkway, Gurnee, IL 60031 | 2012-05-03 |
| 1558637348 | Laura E Novak | Social Worker | 4212 Old Grand Avenue, Gurnne, IL 60031 | 2012-03-27 |
| Find all providers in zip 60031 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649894353 | The Wright Advocate LLC | Counselor | 1800 Nations Dr Ste 117, Gurnee, IL 60031-9171 | 2020-05-29 |
| 1164044798 | Pamela Vernon Stewart | Counselor | 6791 E Mount Vernon Ct, Gurnee, IL 60031-4034 | 2020-05-18 |
| 1699330084 | Mercedes Compton | Counselor | 1790 Nations Dr Ste 214, Gurnee, IL 60031-9176 | 2019-05-01 |
| 1023516010 | Harry Lee Speer | Counselor | 2079 Madison Ave, Gurnee, IL 60031-6300 | 2018-01-25 |
| 1952707051 | Lisa Alexoff | Counselor | 501 N Riverside Dr Ste 111, Gurnee, IL 60031-5918 | 2014-11-17 |
| 1457691651 | Erica Mcilveen | Counselor | 1125 Tri State Pkwy Ste 720, Gurnee, IL 60031-9177 | 2013-02-25 |
| 1972837714 | Willie B Morhead | Counselor | 4220 Tiger Lily Ln, Unit 402, Gurnee, IL 60031-9630 | 2009-09-27 |
| 1811184955 | Ryan Troy Porter | Counselor | 5221 Fredrick Ct, A, Gurnee, IL 60031-6064 | 2007-10-03 |
| 1356562995 | Elizabeth Mika | Counselor | 1662 Vineyard Dr., Gurnee, IL 60031 | 2007-05-01 |
| 1750430278 | Co-operative Partners In Therapy | Counselor | 4343 Old Grand Ave Ste 107c, Gurnee, IL 60031-2701 | 2007-01-10 |
| Find all providers in GURNEE | ||||
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| 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.