MEDICARE: NICK ALAN MESTER

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	103K00000X	Behavior Analyst	RBT-24-380739	IL

General Provider Information

NPI Number	:	1942028659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICK ALAN MESTER

Provider Business Mailing Address
First Line	:	7261 N CRAWFORD AVE
Second Line	:
City	:	LINCOLNWOOD
State	:	IL
Zip	:	60712-2044
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7354 N MILWAUKEE AVE
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-4339
Country	:	US
Telephone Number	:	224-251-8190
Fax Number	:

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

Provider Enumeration Date	:	10/01/2024
Last Update Date	:	10/01/2024

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Directions to “ NICK ALAN MESTER ” Practice Location

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