Individual
MR. NICHOLAS BIRCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
421 E WABASH AVE, RANTOUL, IL 61866-3012
(217) 649-9827
Mailing address
421 E WABASH AVE, RANTOUL, IL 61866-3012
(217) 649-9827
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/06/2021
Last updated
09/11/2025
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