Nicole Centracchio
Individual provider Active NPI Contractor · Arlington Heights, IL
NPI 1629487277 · NPPES record last updated Aug 7, 2014
Key facts
- NPI
- 1629487277
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 227006956 (IL)
- Practice address
- 819 S Dryden PL
Arlington Heights, IL 60005-2765 - Phone
- (773) 562-4610
- NPI assigned
- Aug 7, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227006956 | IL | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 227006956 | IL | Yes |
Addresses
Primary practice location
819 S Dryden PL
Arlington Heights, IL 60005-2765
Mailing address
819 S Dryden PL
Arlington Heights, IL 60005-2765
Phone (773) 562-4610
Other providers in Arlington Heights, IL
- Claire Cebrij
- Samuel Celske
- Center for Emotional Wellness & Personal Development
- Center for Family and Geriatric Medicine, S.C.
- Center of Illinois Home Healthcare, Inc.
- Central Eye Care LTD
- Central Family Care & Weight Loss Clinic LLC
- Cep America Illinois LLP
- Cepamerica Illinois PC
- Cereesa E. Longest MD SC
All providers in Arlington Heights, IL · Contractor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.