Individual
NICHOLAS ANTONIO BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 GOOD SAMARITAN WAY, MOUNT VERNON, IL 62864-2402
(618) 242-4600
Mailing address
58654 VALLEY VIEW DR, WASHINGTON, MI 48094-0901
(586) 246-0714
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036165520
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2020
Last updated
11/03/2023
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