Individual
NIKKI BHARUCHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1948 THREE FARMS AVE, NAPERVILLE, IL 60540-1105
(732) 781-6454
Mailing address
28262 DIEHL RD APT 318, WARRENVILLE, IL 60555-3877
(732) 781-6454
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085009407
IL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/28/2021
Last updated
03/24/2023
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