Individual
NICOLE Z SOMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
747 N RUTLEDGE ST, SPRINGFIELD, IL 62702-6700
(217) 545-6314
(217) 545-2588
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-7578
(217) 545-1884
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
036108365
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036108365
—
IL
Enumeration date
09/23/2005
Last updated
12/07/2020
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