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General NPI Number Information
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NPI Number | 1124909106
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Entity Type | Individual
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Provider Name | NICOLLE BEK
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Gender | Female
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 917 SHERWOOD DR STE 201
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City | LAKE BLUFF
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State | IL
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Zip | 60044-2235
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Country | US
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Telephone | 159-669-6784
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Fax |
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Provider Business Mailing Address
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Address Line | 164 KNIGHTSBRIDGE DR
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City | MUNDELEIN
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State | IL
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Zip | 60060-3244
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Country | US
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Telephone | 224-433-1412
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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 | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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