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General NPI Number Information
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NPI Number | 1740949536
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Entity Type | Individual
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Provider Name | NICOLE M CIKAUSKAS NP-C
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Gender | Female
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Dates
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Enumeration Date | 12/09/2021
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Last Update Date | 11/26/2023
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Provider Practice Location Address
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Address Line | 260 E ARMY TRAIL ROAD SUITE B #111
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City | BARTLETT
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State | IL
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Zip | 60103-3812
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Country | US
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Telephone | 242-202-2039
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Fax |
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Provider Business Mailing Address
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Address Line | 260 E ARMY TRAIL ROAD SUITE B #111
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City | BARTLETT
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State | IL
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Zip | 60103
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Country | US
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Telephone | 224-202-2039
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Fax | 224-298-0565
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209024517
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License Number State | IL
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