Individual
NICOLE VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
140 N ASHLAND AVE, CHICAGO, IL 60607-1802
(312) 633-4972
Mailing address
12608 S THROOP ST, CALUMET PARK, IL 60827-6115
(708) 983-9748
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043105729
IL
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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