Individual
JOHN NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1000 HEALTH CENTER DR, MATTOON, IL 61938
(217) 238-4325
(217) 238-4290
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
209015936
IL
363L00000X
Nurse Practitioner
209015936
IL
363LF0000X
Family Nurse Practitioner
2017028743
MO
363LF0000X
Family Nurse Practitioner
Primary
209015936
IL
Other
Enumeration date
01/02/2018
Last updated
03/11/2025
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