Healthcare Provider Details
I. General information
NPI: 1164352753
Provider Name (Legal Business Name): MS. NICOLE JUDITH HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17907 MILLSTONE RD
HAZEL CREST IL
60429-2173
US
IV. Provider business mailing address
17907 MILLSTONE RD
HAZEL CREST IL
60429-2173
US
V. Phone/Fax
- Phone: 708-663-2017
- Fax:
- Phone: 708-663-2017
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 376K00000X |
| Taxonomy | Nurse's Aide |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: