MEDICARE: NICOLETTE ROSE DALLAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	070.028297	IL

General Provider Information

NPI Number	:	1154161537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLETTE ROSE DALLAS

Provider Business Mailing Address
First Line	:	3586 CABARET TRL
Second Line	:
City	:	OKEMOS
State	:	MI
Zip	:	48864-4082
Country	:	US
Telephone Number	:	517-643-5563
Fax Number	:

Provider Business Practice Location Address
First Line	:	2949 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3536
Country	:	US
Telephone Number	:	773-250-7777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2024
Last Update Date	:	05/31/2024

Similar Medicare Providers

1780510628 — ZAKARY DAVIS DPT
Practice Location Address:

2949 W IRVING PARK RD
CHICAGO, IL
60618-3536

Practice Phone: 773-250-7777
Practice Fax:

1902447469 — MICHELLE DIAZ PTA
Practice Location Address:

3309 N OCONTO AVE
CHICAGO, IL
60634-3536

Practice Phone: 773-895-0753
Practice Fax:

1578698809 — DR. MICHAEL PANEK D.C
Practice Location Address:

3536 N LINCOLN AVE
CHICAGO, IL
60657-1104

Practice Phone: 773-883-8640
Practice Fax:

1861684458 — HISPANIC AMERICAN ENDOSCOPY CENTER, LLC
Practice Location Address:

3536 W FULLERTON AVE
CHICAGO, IL
60647-2443

Practice Phone: 773-772-1212
Practice Fax: 773-697-8305

1992974513 — MS. SANDRA LOPEZ-GARCIA SLP, CCC/L
Practice Location Address:

8505 S KOLIN AVE
CHICAGO, IL
60652-3536

Practice Phone: 773-767-9585
Practice Fax:

1225892904 — LINDSEY N WATTS LSW
Practice Location Address:

3536 W 115TH ST
CHICAGO, IL
60655-3642

Practice Phone: 773-675-0306
Practice Fax:

Directions to “ NICOLETTE ROSE DALLAS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.