Individual
JENNIFER A NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
701 WINTHROP AVE, GLENDALE HEIGHTS, IL 60139-1405
(630) 545-8000
Mailing address
5143 GRAND AVE, DOWNERS GROVE, IL 60515-5120
(630) 742-9419
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209022126
IL
363LA2100X
Acute Care Nurse Practitioner
Primary
209022126
IL
Other
Enumeration date
12/10/2020
Last updated
03/26/2024
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