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NPI Code Detail

MEDICARE: NICHOLAS DONALD CHARMELO

MEDICARE: NICHOLAS DONALD CHARMELO
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
1163WE0003XEmergency Registered Nurse041-240278IL

General Provider Information

NPI Number : 1740809797
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS DONALD CHARMELO
Provider Business Mailing Address
First Line : 1842 BALTIMORE DR
Second Line :
City : ELK GROVE VILLAGE
State : IL
Zip : 60007-2736
Country : US
Telephone Number : 847-208-0695
Fax Number :
Provider Business Practice Location Address
First Line : 5645 W ADDISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60634-2881
Country : US
Telephone Number : 773-282-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2020
Last Update Date : 04/09/2020

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Directions to “ NICHOLAS DONALD CHARMELO ” Practice Location

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