Individual
NICOLE MARIE GEISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1901 W HARRISON ST STE 3350, CHICAGO, IL 60612
(312) 864-6000
Mailing address
1901 W HARRISON ST STE 3350, CHICAGO, IL 60612-3714
(312) 864-6000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036132599
IL
2086X0206X
Surgical Oncology Physician
036132599
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036132599
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036132599
STATE LICENSE
IL
Enumeration date
08/16/2009
Last updated
05/03/2024
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