Individual
NICOLE CHAO KOENEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
7447 W TALCOTT AVE STE 561, CHICAGO, IL 60631-3716
(773) 467-8866
Mailing address
1130 S MICHIGAN AVE APT 3516, CHICAGO, IL 60605-2323
(510) 386-1296
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP134352
TX
Other
Enumeration date
07/26/2017
Last updated
07/26/2017
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