Individual
NICOLE M. GLADCHENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2500 W HIGGINS RD STE 1040, HOFFMAN ESTATES, IL 60169-2049
(847) 884-8096
(847) 490-0978
Mailing address
PO BOX 734240, CHICAGO, IL 60673-4240
(815) 744-8554
(630) 495-1770
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.007852
IL
363A00000X
Physician Assistant
3101-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437492675
BCBSWI
WI
05
—
1437492675
—
IL
05
—
1437492675
—
WI
01
—
2630
MERCYCARE INSURANCE
WI
01
—
K400452296
WI MEDICICARE
WI
Enumeration date
04/05/2013
Last updated
11/14/2022
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