Individual provider Active NPI

Rasheda Latrice Nickelson

  • Social Worker
  • Aurora, IL
National Provider Identifier
1790697092
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
36-2472748 Issued in IL
Practice address
1107 Southgate CT Apt 1107S
Aurora, IL 60504-8971
Phone
(630) 966-4020
NPI assigned
Sep 21, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 36-2472748 IL Primary

Addresses

Primary practice location

1107 Southgate CT Apt 1107S
Aurora, IL 60504-8971

Mailing address

1107 Southgate CT Apt 1107S
Aurora, IL 60504-8971
Phone (630) 966-4020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1790697092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 SOUTHGATE CT APT 1107S",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605048971",
            "telephone_number": "630-966-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 SOUTHGATE CT APT 1107S",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605048971",
            "telephone_number": "630-966-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELSON",
        "first_name": "RASHEDA",
        "middle_name": "LATRICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-21",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "36-2472748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.