Provider Demographics
NPI:1508533290
Name:ADAMCZYK, NIKOLE ANGELICA (FNP)
Entity Type:Individual
Prefix:
First Name:NIKOLE
Middle Name:ANGELICA
Last Name:ADAMCZYK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28594 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-9759
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:82 MILLER DR STE 102
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-5142
Practice Address - Country:US
Practice Address - Phone:630-264-8400
Practice Address - Fax:630-907-1729
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-023899363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty