Healthcare Provider Details

I. General information

NPI: 1801208772
Provider Name (Legal Business Name): NICOLE DOAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S BARTLETT RD STE 106
STREAMWOOD IL
60107-2407
US

IV. Provider business mailing address

820 S BARTLETT RD STE 106
STREAMWOOD IL
60107-2407
US

V. Phone/Fax

Practice location:
  • Phone: 847-713-5013
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.010938
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: