Individual
DR. NICOLE MARY CARMICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PH.D
Contact information
Practice address
415 N 9TH ST, SUITE 4W64, SPRINGFIELD, IL 62702-5303
(217) 545-8000
(217) 757-6519
Mailing address
PO BOX 19635, SPRINGFIELD, IL 62794-9635
(217) 545-8000
(217) 757-6519
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-139643
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036139643
—
IL
Enumeration date
07/13/2013
Last updated
08/16/2016
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