Tidwell, Nichell

Tidwell, Nichell is an individual health care provider with primary practice located at 225 E Chicago Ave , Chicago IL 60611-2991. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is her primary health care specialty. Tidwell, Nichell can be contacted via phone (800) 543-7362.

Contact Information

Primary practice address
225 E Chicago Ave Chicago IL 60611-2991
Phone: (800) 543-7362
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036086376 Illinois
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 207PP0204X 036086376 Illinois

Profile Details

NPI number 1740200765
LBN Legal business name Tidwell, Nichell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Apr 29th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740200765 NPPES
Illinois MEDICAID 036086376

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