Individual
IRIDA NIKOLLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1740 W. TAYLOR ST, CHICAGO, IL 60612
(866) 600-2273
Mailing address
1740 W. TAYLOR ST, CHICAGO, IL 60612
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/25/2012
Last updated
04/25/2012
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