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NPI Code Detail

MEDICARE: NICOLE GLICK

MEDICARE: NICOLE GLICK
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1568390433
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE GLICK
Provider Business Mailing Address
First Line : 513 S DAMEN AVE APT 709
Second Line :
City : CHICAGO
State : IL
Zip : 60612-5592
Country : US
Telephone Number : 858-395-8420
Fax Number :
Provider Business Practice Location Address
First Line : 1653 W CONGRESS PKWY
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3833
Country : US
Telephone Number : 888-352-7874
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2026
Last Update Date : 05/11/2026

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Directions to “ NICOLE GLICK ” Practice Location

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