Individual
NICOLE PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
80 TEMPLETON DR, OSWEGO, IL 60543
(630) 554-3456
Mailing address
80 TEMPLETON DR, OSWEGO, IL 60543-7000
(630) 554-3456
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036148771
IL
208000000X
Pediatrics Physician
125068111
IL
Other
Enumeration date
03/26/2016
Last updated
12/22/2021
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