Provider Demographics
NPI:1467290544
Name:GALINDEZ RODRIGUEZ, NICHOLE ENIX (APN-CNP)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:ENIX
Last Name:GALINDEZ RODRIGUEZ
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:ENIX
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2650 RIDGE AVE STE 1223
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1700
Mailing Address - Country:US
Mailing Address - Phone:847-982-3172
Mailing Address - Fax:
Practice Address - Street 1:965 LAKE ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1292
Practice Address - Country:US
Practice Address - Phone:708-383-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209029990363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner