Individual
MR. BRIAN E NICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1700 W VAN BUREN ST, CHICAGO, IL 60612-5500
(312) 942-6087
Mailing address
2501 CHATHAM RD STE N, SPRINGFIELD, IL 62704-4188
(312) 561-6669
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/31/2017
Last updated
08/21/2023
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