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Individual
NICHOLAS YOUNG
Active
Individual
NICHOLAS YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070012494
IL
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070-012494
LICENSE #
IL
01
—
753210
MEDICARE GROUP
IL
01
—
CF2064
RAILROAD GROUP
IL
01
—
K40726
MEDICARE
IL
Enumeration date
08/30/2006
Last updated
08/07/2015
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