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General NPI Number Information
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NPI Number | 1992138010
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Entity Type | Individual
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Provider Name | NICOLE BROD D.C.
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Gender | Female
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Dates
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Enumeration Date | 08/13/2013
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 1S450 SUMMIT AVE STE 390
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-3976
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Country | US
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Telephone | 630-339-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 80 W HILLCREST BLVD STE 208
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City | SCHAUMBURG
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State | IL
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Zip | 60195-3111
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Country | US
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Telephone | 630-339-5300
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038.012491
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License Number State | IL
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