Individual
MS. JACQUELINE M. NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 S MAIN ST # 1, LOMBARD, IL 60148-2670
(630) 527-3645
Mailing address
506 E HIGHLAND AVE, MOUNT PROSPECT, IL 60056-2138
(847) 807-9116
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209024109
IL
363LF0000X
Family Nurse Practitioner
209.024109
IL
Other
Enumeration date
10/28/2021
Last updated
05/04/2026
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