Nicolette Renee Komie, DEVELOPMENTAL THERAP

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

License

NP51710898P Issued in IL

Practice address

2912 Norway Pine LN
Northbrook, IL 60062-6425

Phone

(847) 275-4115

Fax

(847) 868-9222

NPI assigned

May 16, 2007

Last updated

Nov 16, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Nicolette Renee Polydoros Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nicolette Komie & Associates LLC

  • Developmental Therapist
  • Northbrook, IL
  • NPI 1386464857
  NPD Authorized official
• Nicolette Komie and Associates

  • Early Intervention Provider Agency
  • Vernon Hills, IL
  • NPI 1730578485
  Authorized official Same address or phone
• Dba- Nicolette Komie and Associates

  • Early Intervention Provider Agency
  • Northbrook, IL
  • NPI 1316285869
  NPD (past)

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1679780035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2912 NORWAY PINE LN",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600626425",
            "telephone_number": "847-275-4115",
            "fax_number": "847-868-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2912 NORWAY PINE LN",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600626425",
            "telephone_number": "847-275-4115",
            "fax_number": "847-868-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMIE",
        "first_name": "NICOLETTE",
        "middle_name": "RENEE",
        "credential": "DEVELOPMENTAL THERAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "IL",
            "license": "NP51710898P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLETTE",
            "last_name": "POLYDOROS",
            "middle_name": "RENEE",
            "credential": "DEVELOPMENTAL THERAP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Linda Marie Kolka, APN
• Kristen Koll
• Kollmorgen & Natta, P.C.
• Lizabeth A. Kollmorgen, PSY.D.
• Olivia Kolomiyets
• Demetra Kontakos, RBT-18-69856
• Naomi Kopinsky
• Michael Nicholas Korompilas, D.D.S.
• Alana Korzonas, LSW
• Nicole Kosikowski

• Developmental Therapist in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Developmental Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; 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.