Individual
DR. HANNAH RAE NUCKOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1775 DEMPSTER ST STE E592B, PARK RIDGE, IL 60068-1143
(847) 723-8080
(847) 723-4378
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036138457
IL
207R00000X
Internal Medicine Physician
336099716
IL
Other
Enumeration date
05/18/2012
Last updated
03/10/2023
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