NPI 1447901079
Ieasha Nickelson, RN
Practice location
- Address
- 1440 Clear Dr, Bolingbrook, IL 60490-5575
- Phone
- (708) 949-0969
- Mailing address
- 1112 W Boughton Rd STE 249, Bolingbrook, IL 60440-1508
Registered specialties (2)
Occupational Health Registered Nurse
Primary
Clinical Medical Laboratory
Registry record
- NPI
- 1447901079
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 14 Jan 2022
- Record last updated
- 14 Jan 2022
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.