Individual
MAGALY NICKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
4309 W MEDICAL CENTER DR STE B305, MCHENRY, IL 60050-8418
(847) 802-7400
Mailing address
4309 W MEDICAL CENTER DR STE B305, MCHENRY, IL 60050-8418
(847) 802-7400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
041337837
IL
363L00000X
Nurse Practitioner
Primary
209010594
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209-010594
LICENSE NUMBER
IL
Enumeration date
08/26/2013
Last updated
09/03/2020
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