NICOLE D KING (NPI# 1558334003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558334003 |
| Entity Type | Individual |
| Full Name | NICOLE D KING |
| Credential | MD |
| Practice Address |
9500 S Dorchester Ave Suite 100 Chicago IL 60628-1700 |
| Mailing Address |
Po Box 13677 Belfast ME 04915-4027 |
| Practice Telephone | 7736670768 |
| Practice Fax Number | 7736675529 |
| Mailing Telephone | 7736670768 |
| Mailing Fax Number | 7736675529 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2014-08-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 036-096686 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | TRICARE | 0061621 | 01 |
| IL | BC/BS | 1634166 | 01 |
| IL | RAILROAD MEDICARE | DD6694 | 01 |
| IL | AETNA HMO | 3474878 | 01 |
| IL | AETNA PPO | 7779286 | 01 |
| IL | RAILROAD MEDICARE | P00244611 | 01 |
| IL | 7455146 | CIGNA | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679189872 | Nicole Melissa King | Social Worker | 130 Arizona Ave Ne Unit 408, Atlanta, GA 30307-2257 | 2020-09-22 |
| 1144653312 | Nicole Marie King | Nurse Practitioner | 570 White Pond Dr Ste 100, Akron, OH 44320-4206 | 2013-08-12 |
| 1609190891 | Nicole Marie King | Acupuncturist | 915 E Commerce St, Bridgeton, NJ 08302-4401 | 2010-03-17 |
| 1447326236 | Nicole Marie King | Speech-Language Pathologist | 3615 Braselton Hwy Ste 103, Dacula, GA 30019-5907 | 2006-11-26 |
| 1386277614 | Nicole King | Social Worker | 8623 N Wayne Rd Ste 200, Westland, MI 48185-1137 | 2020-02-14 |
| 1477119816 | Nicole King | Behavior Technician | 3160 Crow Canyon Pl Ste 205, San Ramon, CA 94583-1338 | 2019-05-10 |
| 1386109940 | Nicole King | Behavior Technician | 9600 Nw 25th St Ste Ph, Doral, FL 33172-1416 | 2019-02-07 |
| 1629543426 | Nicole King | Physician Assistant | 5126 W Daybreak Pkwy, South Jordan, UT 84009-5994 | 2018-10-08 |
| 1700367687 | Nicole King | Behavior Technician | 645 Baltimore Annapolis Blvd Ste 216-217, Severna Park, MD 21146-3931 | 2018-08-28 |
| 1538681960 | Nicole Lynn King | Counselor | 31 6th St, Malone, NY 12953-1246 | 2017-07-07 |
| Street Address |
9500 S DORCHESTER AVE SUITE 100 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60628-1700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104857341 | Abraham's Mark Comprehensive Wellness Center | Family Medicine | 9500 S Dorchester Ave, Ste 100, Chicago, IL 60628-1700 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750857942 | Myrna Pledger | Counselor | 259 W. 104th Pl., Chicago, IL 60628 | 2018-10-16 |
| 1073097184 | 4every1 Lab Inc. | Clinical Medical Laboratory | 10723 S Halsted St, Chicago, IL 60628 | 2018-09-24 |
| 1922594613 | Northwest Adult Wellness Center LLC | Clinic/Center | 235 W 95th Suite 3, Chicago, IL 60628 | 2018-07-05 |
| 1285152801 | Brittany Bellamy | Developmental Therapist | 10333 S Prairie, Chicago, IL 60628 | 2017-09-04 |
| 1598293839 | Denise Marie Mercherson | Social Worker | 9561 S. Union, Chicago, IL 60628 | 2017-05-31 |
| 1659821221 | Tca Health Care | Dentist | 1030 E. 130th St, Chicago, IL 60628 | 2016-10-07 |
| 1528432697 | Global Dialysis, LLC | Registered Nurse | 9746 South Harvard Ave., Chicago, IL 60628 | 2015-11-30 |
| 1871966382 | Kirby Rehabilitation, Inc | Clinic/Center | 723 W. 111th St, Chicago, IL 60628 | 2015-11-05 |
| 1851638605 | Marketa Marvanova | Pharmacist | 9501 S. King Drive, Douglas Hall 203-23, Chicago State University College of Pharmacy, Chicago, IL 60628 | 2013-01-14 |
| 1841567377 | Emma Goodman | Pharmacist | 10620 S. Halsted St, Chicago, IL 60628 | 2011-11-29 |
| Find all providers in zip 60628 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606193 | Thatiana Carolina Schulze Goni | Internal Medicine | 5924 N Lincoln Ave Apt 205, Chicago, IL 60659-3736 | 2020-10-11 |
| 1750995742 | Eva Bartaula | Internal Medicine | 1500 S Fairfield Ave # 3, Chicago, IL 60608-1782 | 2020-09-07 |
| 1750994513 | Ranjit Babu Jasaraj | Internal Medicine | 1500 S Fairfield Ave # F-914, Chicago, IL 60608-1782 | 2020-08-30 |
| 1871106005 | Vijay Ketan Reddy | Internal Medicine | 1500 S Fairfield Ave Dept Roomf914, Chicago, IL 60608-1782 | 2020-08-27 |
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1871119172 | Irina Komissarova | Internal Medicine | 916 S Oakley Blvd, Chicago, IL 60612-4230 | 2020-06-22 |
| 1336760719 | Arslan Zahid | Internal Medicine | 5847 S Maryland Ave, Chicago, IL 60637-1463 | 2020-04-27 |
| 1104447572 | Nirmal Desai | Internal Medicine | 5841 S Maryland Ave., M/c 7082, Chicago, IL 60637-1443 | 2020-04-27 |
| 1467072447 | Justin Edmond Sipiora | Internal Medicine | 5841 S. Maryland Ave Mc 7082, Chicago, IL 60637-1443 | 2020-04-20 |
| 1003449612 | Eoht LLC | Internal Medicine | 1718 W North Shore Ave Apt 11, Chicago, IL 60626-4030 | 2020-02-21 |
| Find all providers in CHICAGO | ||||
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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.