MEDICARE: NICOLE D KING MD

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	207R00000X	Internal Medicine Physician	036-096686	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DD6694	OTHER	IL	RAILROAD MEDICARE
2	P00244611	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	1634166	OTHER	IL	BC/BS
4	3474878	OTHER	IL	AETNA HMO
5	7779286	OTHER	IL	AETNA PPO
6	0061621	OTHER	IL	TRICARE
7	CIGNA	OTHER	IL	7455146

General Provider Information

NPI Number	:	1558334003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE D KING MD

Provider Business Mailing Address
First Line	:	PO BOX 13677
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4027
Country	:	US
Telephone Number	:	773-667-0768
Fax Number	:	773-667-5529

Provider Business Practice Location Address
First Line	:	9500 S DORCHESTER AVE
Second Line	:	SUITE 100
City	:	CHICAGO
State	:	IL
Zip	:	60628-1700
Country	:	US
Telephone Number	:	773-667-0768
Fax Number	:	773-667-5529

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	08/18/2014

Similar Medicare Providers

1104857341 — ABRAHAM'S MARK COMPREHENSIVE WELLNESS CENTER, SC
Practice Location Address:

9500 S DORCHESTER AVE , STE 100
CHICAGO, IL
60628-1700

Practice Phone: 773-667-0768
Practice Fax: 773-667-5529

1083011845 — WELL WITH MY SOUL HOLISTIC HEALTH CENTER
Practice Location Address:

9500 S DORCHESTER AVE # 100
CHICAGO, IL
60628-1700

Practice Phone: 773-978-6145
Practice Fax: 773-913-1792

1689413304 — JEFFREEMAN BROWN JR.
Practice Location Address:

9500 S DORCHESTER AVE
CHICAGO, IL
60628-1700

Practice Phone: 773-667-0768
Practice Fax:

1205495355 — SHEZELLE MCCASKILL LCPC
Practice Location Address:

111 W JACKSON BLVD STE 1700
CHICAGO, IL
60604-3597

Practice Phone: 773-263-7611
Practice Fax:

1255282679 — PATRICK MOONEY LPC, NCC
Practice Location Address:

1700 W IRVING PARK RD
CHICAGO, IL
60613-2559

Practice Phone: 312-248-2882
Practice Fax:

1821072372 — MRS. RUBY M. POUW M.D.
Practice Location Address:

1700 W VAN BUREN ST , 5TH FLOOR
CHICAGO, IL
60612-3218

Practice Phone: 312-563-2875
Practice Fax:

Directions to “ NICOLE D KING MD” 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.