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Individual
NICOLE J SWEAZY
Active
Individual
NICOLE J SWEAZY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P. T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070012965
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11581915
CAQH PROVIDER ID
IL
01
—
P00751932
MEDICARE GROUP MEMBER PTAN
IL
Enumeration date
01/16/2007
Last updated
10/27/2009
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