Provider Demographics
NPI:1205379518
Name:TOLL, NANCY (LPN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:TOLL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 SCHILLING AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60411-2610
Mailing Address - Country:US
Mailing Address - Phone:708-756-3466
Mailing Address - Fax:
Practice Address - Street 1:1238 SCHILLING AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-2610
Practice Address - Country:US
Practice Address - Phone:708-756-3466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-18
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043072217164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse