Michael Joseph Nick

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

019031019 Issued in IL

Practice address

1240 Meadow Rd
Northbrook, IL 60062-8300

Phone

(847) 272-9516

Fax

(847) 957-9551

NPI assigned

Apr 16, 2013

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)

Enrolled

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1497198873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 MEADOW RD STE 300",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600623679",
            "telephone_number": "847-272-9516",
            "fax_number": "847-272-9551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 MEADOW RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628300",
            "telephone_number": "847-272-9516",
            "fax_number": "847-957-9551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICK",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-16",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019031019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marianne Newman, LCSW
• Marjorie Harris Newman, PSYD
• Sami Nguyen, DPT
• Tien H Nguyen
• Sheila Ngwenyi Afa Ase
• Nicolette Komie & Associates LLC
• Nina Nielsen
• Betsy Nikodem
• Nirvana Naturopathics, LLC
• Anne Nitsch

• Oral and Maxillofacial Surgery (Dentist) in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.