Nichols, Jacqueline Marie

Nichols, Jacqueline Marie is an individual health care provider with primary practice located at 130 S Main St # 1 , Lombard IL 60148-2670. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Nichols, Jacqueline Marie can be contacted via phone (630) 527-3645.

Contact Information

Primary practice address
130 S Main St # 1 Lombard IL 60148-2670
Phone: (630) 527-3645
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209.024109 Illinois

Profile Details

NPI number 1821752494
LBN Legal business name Nichols, Jacqueline Marie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2021
Last updated Oct 28th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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