NICOLE MALLORY (NPI# 1578991121) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578991121 |
Entity Type | Individual |
Full Name | NICOLE MALLORY |
Credential | PA-C |
Practice Address |
9000 Waukegan Rd Ste 200 Morton Grove IL 60053-2127 |
Mailing Address |
900 Rand Rd Ste 300 Des Plaines IL 60016-2359 |
Practice Telephone | 8473753000 |
Practice Fax Number | 8479291181 |
Mailing Telephone | 8473243976 |
Mailing Fax Number | 8479291154 |
Enumeration Date | 2013-10-17 |
Last Update Date | 2019-04-15 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | 085-006904 | IL | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164069902 | Nicole Mallory | Counselor | 4309 Linglestown Rd, Harrisburg, PA 17112-8624 | 2019-11-27 |
1861751463 | Nicole Sarell Mallory | Physical Therapist | 875 W Poplar Ave Ste 18, Collierville, TN 38017-2568 | 2012-05-16 |
1275809741 | Nicole Christine Mallory | Pediatrics | 300 2nd Ave, Long Branch, NJ 07740-6303 | 2012-03-28 |
1578734844 | Nicole M Mallory | Physician Assistant | 28800 Ryan Rd, Warren, MI 48092-4272 | 2008-03-14 |
Street Address |
9000 WAUKEGAN RD STE 200 |
City | MORTON GROVE |
State | IL |
Zip Code | 60053-2127 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285078766 | Sheela Metgud | Internal Medicine | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2013-04-26 |
1598377202 | Leonard Jack Stewart Iv | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-08-24 |
1336760669 | Lindsay Newton | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-04-28 |
1033745948 | Aaron Gore | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-03-23 |
1215563267 | Dominik Wiest | Orthopaedic Surgery | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-03-20 |
1083248587 | Elaine Chen | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-02-24 |
1881225084 | Jordan Rivett | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-01-28 |
1306489943 | Jacob Babinec | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2019-10-28 |
1750923298 | Marissa Masini | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2019-10-16 |
1710456017 | Maragret Wilson | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2018-11-15 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710536206 | 360 Rehabilitation & Physical Therapy LLC | Clinic/Center | 9041 Moody Avenue, Morton Grove, IL 60053 | 2019-09-06 |
1205312147 | Ziing Healthcare, Inc | Nursing Care | 6126 Lincoln Ave, Suite 1010, Morton Grove, IL 60053 | 2018-07-13 |
1578053674 | Megan Ruffalo | Home Health | 8922 Marion Ave, Morton Grove, IL 60053 | 2018-05-14 |
1215441381 | Kristen Marie Kowalski | Occupational Therapist | 8145 River Dr Ste 101, Morton Grove, IL 60053 | 2017-11-27 |
1760846190 | Lukasz Jarosinski | Physical Therapy Assistant | 8425 N Waukegan, Morton Grove, IL 60053 | 2016-04-12 |
1538547898 | Alysha Gillani | Behavioral Analyst | 9240 Merrill Ave, Morton Grove, IL 60053 | 2015-05-07 |
1043578909 | Jordan Jon Wolf | Social Worker | 9224 Cameron Lane, Morton Grove, IL 60053 | 2012-04-30 |
1427217454 | Amy Sakoda | Specialist | 9400 N Orile, Morton Grove, IL 60053 | 2008-06-05 |
1063679348 | Minsook Do Kroon | Chiropractor | 6021 W Dempster, Morton Grove, IL 60053 | 2008-05-22 |
1023282217 | Simona Balan | Dentist | 6223 W Dempster St, Morton Grove, IL 60053 | 2008-04-17 |
Find all providers in zip 60053 |
Taxonomy Code | 363A00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306450424 | Annie Mannancheril | Physician Assistant | 9114 Waukegan Rd, Morton Grove, IL 60053-2135 | 2020-09-04 |
1598247090 | Mira Akbar Ebalo | Physician Assistant | 9000 Waukegan Rd Ste 210, Morton Grove, IL 60053-2127 | 2018-08-30 |
1790120012 | Sundus Ahsan | Physician Assistant | 6101 Dempster St, Morton Grove, IL 60053-2952 | 2013-04-30 |
1558367482 | Jonathan Garrett | Physician Assistant | 9000 Waukegan Rd, Suite 200, Morton Grove, IL 60053-2127 | 2005-06-24 |
1598377202 | Leonard Jack Stewart Iv | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-08-24 |
1336760669 | Lindsay Newton | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-04-28 |
1033745948 | Aaron Gore | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-03-23 |
1083248587 | Elaine Chen | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-02-24 |
1881225084 | Jordan Rivett | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2020-01-28 |
1306489943 | Jacob Babinec | Physician Assistant | 9000 Waukegan Rd Ste 200, Morton Grove, IL 60053-2127 | 2019-10-28 |
Find all providers in MORTON GROVE |
City | MORTON GROVE |
Zip Code | 60053 |
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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.