MEDICARE: DR. NICOLE A HEYL DPT

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	CP030442T	OR
2	225100000X	Physical Therapist	2305217715	VA

General Provider Information

NPI Number	:	1184352858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLE A HEYL DPT

Provider Business Mailing Address
First Line	:	2122 YORK RD STE 300
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1925
Country	:	US
Telephone Number	:	630-575-6200
Fax Number	:	410-648-4878

Provider Business Practice Location Address
First Line	:	227 WADSWORTH DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-4510
Country	:	US
Telephone Number	:	804-323-7874
Fax Number	:	804-323-7879

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

Provider Enumeration Date	:	08/10/2022
Last Update Date	:	05/26/2026

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