Individual
NICOLE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2035 S STATE ST UNIT 16042, CHICAGO, IL 60616-8201
(312) 871-1811
Mailing address
2035 S STATE ST UNIT 16042, CHICAGO, IL 60616-8201
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
041.480844
IL
225200000X
Physical Therapy Assistant
160.005685
IL
Other
Enumeration date
07/09/2013
Last updated
07/26/2024
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