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NPI Code Detail

MEDICARE: NICHOLE DEKOSTER DPT

MEDICARE: NICHOLE DEKOSTER 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
1225100000XPhysical Therapist2026023749MO

General Provider Information

NPI Number : 1942140249
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLE DEKOSTER 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 : 630-575-6000
Fax Number :
Provider Business Practice Location Address
First Line : 4337 BUTLER HILL RD STE L
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63128-3735
Country : US
Telephone Number : 314-487-7000
Fax Number : 314-487-7001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2026
Last Update Date : 06/15/2026

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