Individual provider · Type 1 NPI
Nichole Schupbach, PNP
Pediatric Nurse Practitioner · Chicago, IL
NPI number
1104455633
Active
Practice location
225 E Chicago Ave
Chicago, IL 60611-2991
Mailing address
2510 N Wayne Ave Apt 209
Chicago, IL 60614-2143
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | RN301093 (GA) |
| Pediatric Registered Nurse | 163WP0200X | 041422092 (IL) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1104455633
Nichole Schupbach, PNP's National Provider Identifier is 1104455633, issued on Apr 6, 2020. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Chicago, IL. The record was last updated on May 20, 2021.