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General NPI Number Information
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NPI Number | 1073271631
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Entity Type | Organization
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Legal Business Name | NIKKIE EVANS, PLLC
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Dates
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Enumeration Date | 12/01/2021
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 175 OLDE HALF DAY RD STE 140-9
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069-3062
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Country | US
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Telephone | 847-790-4959
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Fax |
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Provider Business Mailing Address
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Address Line | 5 REVERE DR STE 200
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City | NORTHBROOK
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State | IL
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Zip | 60062-8000
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Country | US
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Telephone | 847-790-4959
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Fax |
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | NIKKIE EVANS
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Credential | MS, LCPC
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Telephone | 847-790-4959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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