Individual provider Active NPI

Margaret M Nicholson, RN

  • Nutrition Support Registered Nurse
  • Chicago, IL
National Provider Identifier
1396322475
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Support Registered NurseTaxonomy code 163WN1003X
License
495610 Issued in IL
Practice address
1017 W Washington Blvd Unit 6D
Chicago, IL 60607-2112
Phone
(708) 670-0797
NPI assigned
Mar 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Support Registered Nurse 163WN1003X 495610 IL Primary

Addresses

Primary practice location

1017 W Washington Blvd Unit 6D
Chicago, IL 60607-2112

Mailing address

4052 Grand Ave
Western Sprgs, IL 60558-1135
Phone (708) 670-0797

Other practice location 1

4052 Grand Ave
Western Sprgs, IL 60558-1135
Phone (708) 670-0797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
495610ILMDNutrition Support Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1396322475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4052 GRAND AVE",
            "city": "WESTERN SPRGS",
            "state": "IL",
            "postal_code": "605581135",
            "telephone_number": "708-670-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 W WASHINGTON BLVD UNIT 6D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072112",
            "telephone_number": "708-670-0797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4052 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Western Sprgs",
            "state": "IL",
            "postal_code": "605581135",
            "country_code": "US",
            "telephone_number": "708-670-0797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "MARGARET",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN1003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "IL",
            "license": "495610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.