Individual
MISS NICOLE MARIE BAUKNECHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
984 WILLOW RD STE H, NORTHBROOK, IL 60062-6821
(888) 938-3838
(888) 919-1083
Mailing address
1660 FEEHANVILLE DR STE 200, MOUNT PROSPECT, IL 60056-6036
(847) 823-3185
(847) 823-3318
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.004867
IL
Other
Enumeration date
03/25/2014
Last updated
04/28/2022
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