Individual
DR. JOHN D NICOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
259 E ERIE ST, SUITE 2300, CHICAGO, IL 60611-2987
(312) 926-6000
(312) 926-6332
Mailing address
259 E ERIE ST, SUITE 2300, CHICAGO, IL 60611-2987
(312) 926-6000
(312) 926-6332
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036077725
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036077725
—
IL
01
—
110119439
RR MEDICARE
IL
Enumeration date
08/30/2005
Last updated
05/16/2016
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