Norris, Nicole Edith

Norris, Nicole Edith is an individual health care provider with primary practice located at 600 E 1St St , Spring Valley IL 61362-1512. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Norris, Nicole Edith can be contacted via phone (815) 663-5981.

Contact Information

Primary practice address
600 E 1St St Spring Valley IL 61362-1512
Fax: (815) 663-5982
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-111100 Illinois

Profile Details

NPI number 1689679599
LBN Legal business name Norris, Nicole Edith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Apr 15th, 2013 - about 11 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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Identifiers

StateTypeNumberIssuer
All States NPI 1689679599 NPPES
Illinois MEDICAID 036111100

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