Peter Warner Nichols Jr., MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

036.118548 Issued in IL

Practice address

1400 E Irving Park Rd
Streamwood, IL 60107-3201

Phone

(630) 837-9000

NPI assigned

Jun 19, 2007

Last updated

Nov 16, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• IL PPO Downstate
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
• IL HMO C-SNP
• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• BHC Streamwood Hospital Inc.

  dba Streamwood Behavioral Health Center

  • Psychiatric Hospital
  • Streamwood, IL
  • NPI 1619916822
  Medicare reassignment NPD
• Chicago BH Hospital, LLC

  dba Montrose Behavioral Health Hospital

  • Psychiatric Hospital
  • Chicago, IL
  • NPI 1972384758
  Medicare reassignment NPD
• Edgewood Clinical Services, P.C.

  dba LifeStance

  • Psychologist
  • Naperville, IL
  • NPI 1295914646
  Medicare reassignment NPD
• Lutheran Social Services of Illinois

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1063637684
  Medicare reassignment NPD
• Chicago BH Hospital, LLC

  dba Montrose Behavioral Health Hospital

  • Psychiatric Hospital
  • Chicago, IL
  • NPI 1134900913

  Child & Adolescent Psychiatry

  NPD
• Chicago BH Hospital, LLC

  dba Montrose Behavioral Health Hospital

  • Psychiatric Hospital
  • Chicago, IL
  • NPI 1336800119
  NPD
• Lutheran Social Services of Illinois

  dba Welcoming Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1144613746

  Child & Adolescent Psychiatry

  NPD
• Psychology Specialists LTD

  dba LifeStance Health

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)
• Siebert Moazzam P C

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Peoria, IL
  • NPI 1396780292
  NPD (past)
• Psychology Specialists LTD

  dba LifeStance Health

  • Clinical Psychologist
  • Las Vegas, NV
  • NPI 1003473448
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1013112143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 W DIVERSEY PKWY APT 2W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141468",
            "telephone_number": "626-253-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E IRVING PARK RD",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601073201",
            "telephone_number": "630-837-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "PETER",
        "middle_name": "WARNER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-19",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036.118548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harjit Kaur Naroo
• Jenifer Negrete
• Cherish L Nelson, APRN, FNP
• New Hope Counseling LTD.
• New Image Dental LTD
• Colleen Nigliaccio
• Eric Ward Nolan, MD
• Noor Pediatric Therapy
• Northwest Podiatry Center
• David William O'Brian, D.P.M.

• Child & Adolescent Psychiatry Physician in Streamwood, IL
• Providers in Streamwood, IL by specialty
• Child & Adolescent Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.