Micah Joseph Holland, MS, ATC, PES, CES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096002501 Issued in IL

Practice address

205 W Wacker Dr
Suite 1020
Chicago, IL 60606-1216

Phone

(312) 640-0329

NPI assigned

Jan 12, 2012

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1144590712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 E SOPER ST",
            "city": "WINNEBAGO",
            "state": "IL",
            "postal_code": "610889770",
            "telephone_number": "815-222-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W WACKER DR",
            "address_2": "SUITE 1020",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061216",
            "telephone_number": "312-640-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "MICAH",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MS, ATC, PES, CES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096002501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hattie Nichole Holland, MA, NCC, LPC
• Jarrell Gabe Holland, MD
• Katie Lynne Holland, MD
• Matthew Hill Holland
• Merle S Holland, EDD
• Peter M Holland, MD
• Spring Holland
• Thomas Monroe Holland
• Tiffany Holland
• Chana Hollander, SLP-CCC

• Athletic Trainer in Chicago, IL
• Providers in Chicago, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.