Individual
MR. NOLAN PAUL HERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4700 MEMORIAL DR, DIV WUPI NEUROSURGERY, STE 230, BELLEVILLE, IL 62226-5373
(618) 257-5902
(618) 257-6671
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(618) 257-5902
(618) 257-6671
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085010528
IL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220145775
—
MO
Enumeration date
04/29/2024
Last updated
02/20/2026
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