Peacock, Nicholas Tyler

Peacock, Nicholas Tyler is an individual health care provider with primary practice located at 3001 Cherry Hills Dr , Champaign IL 61822-7586. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant, which is considered as his primary health care specialty. Peacock, Nicholas Tyler can be contacted via phone (217) 721-7799.

Contact Information

Primary practice address
3001 Cherry Hills Dr Champaign IL 61822-7586
Phone: (217) 721-7799
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant 224Z00000X 057.005500 Illinois

Profile Details

NPI number 1316528797
LBN Legal business name Peacock, Nicholas Tyler
Credentials L/COTA
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2021
Last updated Apr 18th, 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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