Individual
NICOLE M TRITTSCHUH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
801 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3204
(847) 362-2900
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.006175
IL
363AS0400X
Surgical Physician Assistant
085-006175
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085006175
STATE LICENSE
IL
Enumeration date
02/22/2017
Last updated
01/13/2025
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