Nichell Tidwell
Emergency Physician Pediatric Emergency Physician
225 E Chicago Ave
Chicago
, Illinois 60611-2991
Nichell Tidwell
Emergency Physician Pediatric Emergency Physician
225 E Chicago Ave
Chicago
, Illinois 60611-2991
(800) 543-7362
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About
Features
Specialties
- Emergency Physician
- Pediatric Emergency Physician
Languages spoken
- English
Location
First Address
- Nichell Tidwell
- 225 E Chicago Ave # 152
- Chicago, IL
- Zip : 60611-2991
- Phone : (800) 543-7362
Second Address
- Nichell Tidwell
- 225 E Chicago Ave
- Chicago, IL
- Zip : 60611-2991
- Phone : (800) 543-7362
Reviews
FAQs
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What type of doctor is Nichell Tidwell
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Is Nichell Tidwell accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207P00000X | Emergency Physician | 036086376 | IL |
| Y | 207PP0204X | Pediatric Emergency Physician | 036086376 | IL |
National Provider Identifier
| NPI | 1740200765 |
|---|---|
| Provider Name | Nichell Tidwell |
| First Address | Chicago, IL 60611-2991 |
| Second Address | Chicago, IL 60611-2991 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/07/2006 |
| Last Update Date | 29/04/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036086376 | (05) | IL |
| K38060 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.