Healthcare Provider Details

I. General information

NPI: 1174092050
Provider Name (Legal Business Name): NICOLE HODGKINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2018
Last Update Date: 04/26/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 W INSTITUTE PL STE 500
CHICAGO IL
60610-8792
US

IV. Provider business mailing address

213 W INSTITUTE PL STE 500
CHICAGO IL
60610-8792
US

V. Phone/Fax

Practice location:
  • Phone: 773-242-7214
  • Fax:
Mailing address:
  • Phone: 772-242-7214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: