Individual
MR. GREGORY ALAN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, MSN, FNP-BC
Contact information
Practice address
1 WESTBROOK CORPORATE CTR STE 300, WESTCHESTER, IL 60154-5709
(866) 949-0108
Mailing address
2115 WATER CHASE DR, NEW LENOX, IL 60451-4813
(815) 325-3978
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209008721
IL
363LF0000X
Family Nurse Practitioner
209.008721
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770860124
NPI
IL
Enumeration date
03/28/2011
Last updated
04/18/2022
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