Courtney Keyonna Nichols

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

041513709 Issued in IL

Practice address

4321 S Saint Lawrence Ave Apt 2S
Chicago, IL 60653-2730

Phone

(312) 636-0101

NPI assigned

Sep 29, 2026

Last updated

Sep 29, 2026By the provider in NPPES

Sex

Female

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

State licenses

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

{
    "created_epoch": "1790640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1598679516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 S SAINT LAWRENCE AVE UNIT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606532730",
            "telephone_number": "312-636-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 S SAINT LAWRENCE AVE APT 2S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606532730",
            "telephone_number": "312-636-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "COURTNEY",
        "middle_name": "KEYONNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-29",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "041513709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherise Nicholas, LSW
• Allison R. Nichols, LCSW
• Anthony Richard Nichols
• Brooke Nichols, RDN
• Carmel Nichols, MD
• Jeremy Andrew Nichols, RPH
• Kara Nichols, PH.D.
• Lauren Nichols, PSYD
• Leah Ellen Nichols, PT, DPT
• Natasha L Nichols, M.D.

• Student in an Organized Health Care Education/Training Program in Chicago, IL
• Providers in Chicago, IL by specialty
• Student in an Organized Health Care Education/Training Program in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.