Organization
ADVOCATE CHILDREN'S HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA MARIE NICOLL MS, CGC (GENETIC COUNSELOR)
(708) 684-4561
Entity
Organization
Contact information
Practice address
4440 W 95TH ST, ROOM 0019H, OAK LAWN, IL 60453-2600
(708) 684-4561
(708) 684-4763
Mailing address
4440 W 95TH ST, ROOM 0019H, OAK LAWN, IL 60453-2600
(708) 684-4561
(708) 684-4763
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
247000065
IL
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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