Healthcare Provider Details

I. General information

NPI: 1972486116
Provider Name (Legal Business Name): NICOLE SWEETMAN DNP, APRN, AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 W HARRISON ST
CHICAGO IL
60612-3801
US

IV. Provider business mailing address

821 W GUNNISON ST APT 2
CHICAGO IL
60640
US

V. Phone/Fax

Practice location:
  • Phone: 561-827-2073
  • Fax:
Mailing address:
  • Phone: 561-827-2073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number209.036151
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041472545
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: