Individual
MISS NICHELLE J PAJEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.,
Contact information
Practice address
6131 DEMPSTER ST, MORTON GROVE, IL 60053-2953
(847) 967-5010
(847) 967-5147
Mailing address
6131 DEMPSTER ST, MORTON GROVE, IL 60053-2953
(847) 967-5010
(847) 967-5147
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
85002728
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85002728
PROFESSIONAL LICENCE
IL
Enumeration date
10/24/2006
Last updated
12/14/2021
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