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NPI Code Detail

MEDICARE: NICOLE PRIEST

MEDICARE:   NICOLE  PRIEST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistIL

General Provider Information

NPI Number : 1538344262
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE PRIEST
Provider Business Mailing Address
First Line : 5532 N CLARK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-1214
Country : US
Telephone Number : 773-784-7348
Fax Number : 773-784-1408
Provider Business Practice Location Address
First Line : 5532 N CLARK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-1214
Country : US
Telephone Number : 773-784-7348
Fax Number : 773-784-1408
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2007
Last Update Date : 12/31/2007

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Directions to “ NICOLE PRIEST ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.