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General NPI Number Information
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NPI Number | 1003657883
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Entity Type | Individual
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Provider Name | NICOLE HALEY SULIMA DNP
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Gender | Female
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 1620 W HARRISON ST
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City | CHICAGO
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State | IL
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Zip | 60612-3801
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Country | US
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Telephone | 312-942-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1250 W VAN BUREN ST APT 302
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City | CHICAGO
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State | IL
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Zip | 60607-2820
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Country | US
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Telephone | 505-280-4798
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041478225
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 209029821
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License Number State | IL
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