NICOLE M TRITTSCHUH (NPI# 1316486459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316486459 |
| Entity Type | Individual |
| Full Name | NICOLE M TRITTSCHUH |
| Credential | PA-C |
| Practice Address |
420 N Il Route 31 Crystal Lake IL 60012 |
| Mailing Address |
420 N Il Route 31 Crystal Lake IL 60012-3709 |
| Practice Telephone | 8153565200 |
| Practice Fax Number | 8153565262 |
| Mailing Telephone | 8153565200 |
| Mailing Fax Number | 8153565262 |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2018-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | STATE LICENSE | 085006175 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10370 Haligus Rd Ste 201, Huntley, IL 601429582 | 8153565200 | 8153565262 |
| Street Address |
420 N IL ROUTE 31 |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467485128 | Gordon D Husby | Physical Therapist | 420 N Il Route 31, Crystal Lake, IL 60012-3711 | 2006-07-08 |
| 1134648389 | Ryan Miguel Colon | Physician Assistant | 420 N Il Route 31, Crystal Lake, IL 60012 | 2017-09-19 |
| 1497295125 | Alexander J Hembrey | Physician Assistant | 420 N Il Route 31, Crystal Lake, IL 60012 | 2017-02-28 |
| 1356883599 | Centegra Primary Care LLC | Family Medicine | 420 N Il Route 31, Crystal Lake, IL 60012-3709 | 2016-11-04 |
| 1770954125 | Lisa Zemaitis | Physical Therapy Assistant | 420 N Il Route 31, Crystal Lake, IL 60012-3709 | 2015-10-12 |
| 1336552199 | Nicole Ashley Fox | Physical Therapist | 420 N Il Route 31, Crystal Lake, IL 60012-3711 | 2014-06-09 |
| 1497168355 | Heather Michelle Murnane | Occupational Therapist | 420 N Il Route 31, Crystal Lake, IL 60012-3711 | 2014-06-09 |
| 1528487436 | Michael Christopher Ciccotti | Orthopaedic Surgery | 420 N Il Route 31, Crystal Lake, IL 60012-3709 | 2014-04-08 |
| 1326483280 | Mark Andrew Rotert | Nurse Practitioner | 420 N Il Route 31, Crystal Lake, IL 60012 | 2013-05-06 |
| 1548519986 | Stephanie H Goede | Physician Assistant | 420 N Il Route 31, Crystal Lake, IL 60012 | 2012-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033574629 | Joan M Ryan | Counselor | 610 N Route 31, Suite E, Crystal Lake, IL 60012 | 2015-12-23 |
| 1285972331 | Lauren Elyse Westerman | Physical Therapist | 1000 Brighton Ln, Crystal Lake, IL 60012 | 2013-01-24 |
| 1447537469 | Sean Gale | Pharmacist | 135 Carmella Dr, Crystal Lake, IL 60012 | 2011-11-04 |
| 1477836625 | Judy Meekyung Fakhouri | Pharmacist | 315 N. Route 31, Crystal Lake, IL 60012 | 2011-09-23 |
| 1730462136 | Leslie Dawn Weckerlin | Pharmacist | 315 N Route 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1639452188 | Laura Jean Galles | Pharmacist | 315 N. Routet 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1326320516 | Stacey Jean Knuth | Pharmacist | 315 North Route 31, Crystal Lake, IL 60012 | 2011-09-13 |
| 1356469803 | Donn Orien Humphries | Chiropractor | 690 N Route 31, Suite F, Crystal Lake, IL 60012 | 2007-03-26 |
| 1538204508 | Midwest Physical Therapy Ctr | Clinic/Center | 630 N Rt 31, Suite 103, Crystal Lake, IL 60012 | 2007-02-20 |
| 1356488415 | Charlotte Joy Parcels | Social Worker | 8600 Route 14, Suite 110, Crystal Lake, IL 60012 | 2007-01-30 |
| Find all providers in zip 60012 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639651060 | Scott M. Detloff | Physician Assistant | 415 E Congress Pkwy Ste A, Crystal Lake, IL 60014-6248 | 2018-09-01 |
| 1497295125 | Alexander J Hembrey | Physician Assistant | 420 N Il Route 31, Crystal Lake, IL 60012 | 2017-02-28 |
| 1942747480 | Christopher L Ballinger | Physician Assistant | 420 N. Il Route 31, Crystal Lake, IL 60012 | 2017-01-23 |
| 1548519986 | Stephanie H Goede | Physician Assistant | 420 N Il Route 31, Crystal Lake, IL 60012 | 2012-08-30 |
| 1902092109 | Jeremy A Houtakker | Physician Assistant | 750 E Terra Cotta Ave, Suite C, Crystal Lake, IL 60014-3621 | 2007-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477169522 | Priority Assist Pllc | Physician Assistant | 48 Glenda Ln, Plano, IL 60545-9652 | 2020-09-23 |
| 1154944478 | Diana Goldak | Physician Assistant | 3855 N Parkway Dr Apt 3a, Northbrook, IL 60062-7218 | 2020-05-20 |
| 1033742580 | Colleen Courtney | Physician Assistant | 218 S Driftwood Trl, Mchenry, IL 60050-5454 | 2020-02-12 |
| 1326678962 | Nina Kodros | Physician Assistant | 301 Madison St Ste 280, Joliet, IL 60435-6672 | 2020-01-23 |
| 1689218190 | Jennifer Richman | Physician Assistant | 1890 Silver Cross Blvd Ste 410, New Lenox, IL 60451-9547 | 2019-10-29 |
| 1710547625 | Nadia Khan | Physician Assistant | 4543 N Malden St Apt 1s, Chicago, IL 60640-5687 | 2019-06-13 |
| 1962065516 | Jorge Mantilla | Physician Assistant | 5540 N Kimball Ave Apt 3e, Chicago, IL 60625-4674 | 2019-04-18 |
| 1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
| 1770041949 | Laura Ann Ryan | Physician Assistant | 840 S Wood St Ste 417, Chicago, IL 60612-4325 | 2019-03-06 |
| 1548739782 | Helen Finke | Physician Assistant | 880 W Central Rd Ste 3300, Arlington Heights, IL 60005-2366 | 2018-11-16 |
| Find all providers with the same taxonomy | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60012 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.