Individual
DR. NICOLE Y OTTENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1000 HEALTH CENTER DR, MATTOON, IL 61938-9261
(217) 258-2551
(217) 258-2256
Mailing address
1005 HEALTH CENTER DR STE 201, MATTOON, IL 61938-4693
(217) 238-6055
(217) 258-2216
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-126162
IL
207Q00000X
Family Medicine Physician
02003351A
IN
Other
Enumeration date
09/26/2008
Last updated
01/04/2019
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