Individual
DR. JEFFREY WILLIAM NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18440 GOVERNORS HWY, HOMEWOOD, IL 60430-2911
(708) 798-2191
(708) 798-2317
Mailing address
694 W IRVING PARK RD APT B8, CHICAGO, IL 60613-3161
(773) 929-3685
(708) 798-2317
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036069554
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036069554
—
IL
Enumeration date
09/11/2006
Last updated
03/07/2023
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