Individual
NICOLE MICHELE HAYWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2641 W HARRISON ST, CHICAGO, IL 60612-3420
(630) 377-1188
Mailing address
2900 FOXFIELD RD STE 102, ST CHARLES, IL 60174-5799
(630) 377-1188
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.006881
IL
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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