Nicholas Licudine, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.012923 Issued in IL

Practice address

1841 S Calumet Avenue
Unit 1610
Chicago, IL 60616

Phone

(312) 613-5243

NPI assigned

Mar 31, 2008

Sex

Male

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)

Enrolled

Practice roles

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

• Alphazeta Healthcare Services LLC

  • Home Health Agency
  • Chicago, IL
  • NPI 1811197429
  NPD (past)

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1942472980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 S CALUMET AVENUE",
            "address_2": "UNIT 1610",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164814",
            "telephone_number": "312-613-5243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 S CALUMET AVENUE",
            "address_2": "UNIT 1610",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60616",
            "telephone_number": "312-613-5243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICUDINE",
        "first_name": "NICHOLAS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-31",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.012923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marla Lichterman, LCSW
• Asher Eli Lichtig, MD
• Alex Lickerman, M.D.
• Lauren Lickert, PMHNP-BC
• Licudine & Licudine MD SC
• Normita Madamba Licudine, MD
• Thomas Jackson Lidahl
• Dominic Marcellus Liddell
• Sarah Liddell, LCPC
• Erica Christine Liddicoat

• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.