Healthcare Provider Details

I. General information

NPI: 1386244358
Provider Name (Legal Business Name): NICHOLE ERHARDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2020
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22285 N PEPPER RD STE 103
LAKE BARRINGTON IL
60010-2539
US

IV. Provider business mailing address

22285 N PEPPER RD STE 103
LAKE BARRINGTON IL
60010-2539
US

V. Phone/Fax

Practice location:
  • Phone: 224-357-8133
  • Fax: 224-512-4622
Mailing address:
  • Phone: 224-357-8133
  • Fax: 224-512-4622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209022284
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: