Nicole A Blackowicz, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

625 Enterprise Dr
Oak Brook, IL 60523-8813

Phone

(715) 558-1268

NPI assigned

Jan 18, 2019

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

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1740754183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 FIELDCREST DR",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600605352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "715-558-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKOWICZ",
        "first_name": "NICOLE",
        "middle_name": "A",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget Bicek, LPC
• Lindsay Bicknell-Hentges, PHD
• Konrad Artur Bienia, MD
• Kaitlin R Biondo, M.H.S., CCC-SLP
• Jason Cordell Birnholz, M.D.
• Sarah Block, DPT
• Kerstin Blumhardt, MSW
• Samina Bokhari, M.D.
• Dalton Jared Boland, DPT
• Kyle Bonesteel, PHD

• Athletic Trainer in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.