Provider Demographics
NPI:1740448927
Name:HUFFMAN, NICOLE PAPASTATHIS (MD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:PAPASTATHIS
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:PAPASTATHIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:400 SKOKIE BLVD
Mailing Address - Street 2:SUITE 475
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2816
Mailing Address - Country:US
Mailing Address - Phone:847-272-4433
Mailing Address - Fax:847-272-4434
Practice Address - Street 1:400 SKOKIE BLVD
Practice Address - Street 2:SUITE 475
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2816
Practice Address - Country:US
Practice Address - Phone:847-272-4433
Practice Address - Fax:847-272-4434
Is Sole Proprietor?:No
Enumeration Date:2008-05-24
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.130234207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology