Individual
NICOLLE CORA BARTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8N595 GINGERWOOD LN, ELGIN, IL 60124
(224) 730-8543
Mailing address
8N595 GINGERWOOD LN, ELGIN, IL 60124
(224) 730-8543
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173976622
—
IL
Enumeration date
01/13/2023
Last updated
01/13/2023
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