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NPI Code Detail

MEDICARE: NICOLE K SONI MA, LCPC

MEDICARE: NICOLE K SONI MA, LCPC
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
1101YP2500XProfessional CounselorIL

General Provider Information

NPI Number : 1700444999
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE K SONI MA, LCPC
Provider Business Mailing Address
First Line : 1 PEMBURY WAY
Second Line :
City : SOUTH BARRINGTON
State : IL
Zip : 60010-6153
Country : US
Telephone Number : 224-256-2250
Fax Number : 224-256-2615
Provider Business Practice Location Address
First Line : 3660 N LAKE SHORE DR STE 201
Second Line :
City : CHICAGO
State : IL
Zip : 60613-5302
Country : US
Telephone Number : 773-759-5126
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2019
Last Update Date : 03/25/2024

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