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General NPI Number Information
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NPI Number | 1154662633
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Entity Type | Organization
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Legal Business Name | NICOLE A. DUGGER
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Dates
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Enumeration Date | 03/08/2013
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 450 E 22ND ST STE 152
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City | LOMBARD
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State | IL
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Zip | 60148-6175
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Country | US
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Telephone | 847-858-7483
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Fax |
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Provider Business Mailing Address
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Address Line | 450 E 22ND ST STE 152
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City | LOMBARD
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State | IL
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Zip | 60148-6175
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Country | US
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Telephone | 630-446-0586
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. NICOLE A DUGGER
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Credential | LCPC, CADC
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Telephone | 847-858-7483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 180007191
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License Number State | IL
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