Individual
NICOLE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8296
(847) 984-5689
Mailing address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8296
(847) 984-5689
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.462351
IL
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
041.462351
IL
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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