NICOLE MOURILLON (NPI# 1669456018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669456018 |
| Entity Type | Individual |
| Full Name | NICOLE MOURILLON |
| Credential | M.D. |
| Practice Address |
901 Macarthur Blvd Munster IN 46321-2901 |
| Mailing Address |
6923 S Cregier Ave Chicago IL 60649-1407 |
| Practice Telephone | 2198364511 |
| Practice Fax Number | 2198367048 |
| Mailing Telephone | 7733636607 |
| Mailing Fax Number | 7733636607 |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2007-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM BCBS | 000000531125 | 01 |
| IN | RAILROAD | P00408759 | 01 |
| IL | BCBS | 90001082 | 01 |
| Street Address |
901 MACARTHUR BLVD |
| City | MUNSTER |
| State | IN |
| Zip Code | 46321-2901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740273077 | Matthew Fitzpatrick | Radiology | 901 Macarthur Blvd, Radiology Department, Munster, IN 46321-2901 | 2005-08-23 |
| 1033710561 | Jonathan Chua | Pharmacist | 901 Macarthur Blvd, Munster, IN 46321-2901 | 2020-11-02 |
| 1649879842 | John Hurley Jr. | Nurse Anesthetist, Certified Registered | 901 Macarthur Blvd, Munster, IN 46321-2959 | 2020-10-20 |
| 1942812391 | Cathrine Roels | Pharmacist | 901 Macarthur Blvd, Munster, IN 46321-2901 | 2020-08-18 |
| 1396355988 | Nicole Kaminsky | Pharmacist | 901 Macarthur Blvd, Munster, IN 46321-2901 | 2020-08-07 |
| 1992314819 | Jennifer Biank | Registered Nurse | 901 Macarthur Blvd, Munster, IN 46321-2959 | 2020-07-27 |
| 1598374704 | Amber Nicole Hudson | Pharmacist | 901 Macarthur Blvd, Munster, IN 46321-2901 | 2020-07-24 |
| 1700495942 | Alexa Catherine Klimek | Pharmacist | 901 Macarthur Blvd, Munster, IN 46321-2901 | 2020-07-23 |
| 1437768611 | Hailey Corrinne Estes | Pharmacist | 901 Macarthur Blvd, Munster, IN 46321-2901 | 2020-07-23 |
| 1154939007 | Betsy Abraham | Pharmacist | 901 Macarthur Blvd, Munster, IN 46321-2901 | 2020-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154959179 | Munster Surgery Center LLC | Clinic/Center | 1950 45thstreet, Unit 101, Munster, IN 46321 | 2020-03-27 |
| 1467092668 | Barbara Armstrong-whitaker | Counselor | 8855 Columbia Ave, Munster, IN 46321 | 2020-01-15 |
| 1427537661 | Courtney Szydelko | Physical Therapist | 759 45th St Ste 202, Munster, IN 46321 | 2018-08-08 |
| 1407341787 | New Harvest Therapy Services, Inc. | Clinic/Center | 8124 Calumet Ave Ste B, Munster, IN 46321 | 2018-06-28 |
| 1043717945 | Region Eye Care LLC | Optometrist | 10413 Calumet Ave., Munster, IN 46321 | 2018-04-09 |
| 1003318122 | Jean M Nanos | Psychologist | 8124 Calumet Ave, Munster, IN 46321 | 2018-03-05 |
| 1841706330 | Avalon Marciniak | Speech-Language Pathologist | 1950 West 45th St., Munster, IN 46321 | 2017-12-19 |
| 1104330034 | Hinsdale Orthopaedic Associates, S.c. | Orthopaedic Surgery | 8141 S Calumet Ave, Unit 1, Munster, IN 46321 | 2017-11-30 |
| 1457871774 | Shannon Nicole Riley | Behavior Technician | 8113 Howard Ave., Munster, IN 46321 | 2017-06-27 |
| 1679017313 | Infomedica | Internal Medicine | 10010 Donald S Powers Dr, Munster, IN 46321 | 2016-12-15 |
| Find all providers in zip 46321 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346871217 | Nw Indiana Ep, LLC | Emergency Medicine | 7904 Cabela Dr, Hammond, IN 46324-2950 | 2020-01-30 |
| 1801383278 | Midwest Emergency Medicine, Inc. | Emergency Medicine | 520 S 7th Street, Er, Vincennes, IN 47591-1038 | 2018-04-20 |
| 1285994434 | Aaron Brooks Crofoot | Emergency Medicine | 229 W North Shore Dr, South Bend, IN 46617-1142 | 2012-05-22 |
| 1689842262 | James Scott Frasure | Emergency Medicine | 4030 W Breezewood Ct, Bloomington, IN 47404-9132 | 2008-02-15 |
| 1831290956 | Suzanne M Coleman | Emergency Medicine | 3124 E State Blvd Ste 2b, Fort Wayne, IN 46805-4763 | 2006-09-25 |
| 1194772681 | Paula Lange | Emergency Medicine | 3252 Tantara Bnd, Carmel, IN 46032-8733 | 2006-05-28 |
| 1982658886 | Robert L Goddard Jr. | Emergency Medicine | 817 W Rosewood Dr, Bloomington, IN 47404-1849 | 2006-05-22 |
| 1295796985 | Thomas S Spencer | Emergency Medicine | 104 E Culver Rd, Suite 103, Knox, IN 46534-2216 | 2006-03-31 |
| 1609844166 | Joseph V Lazzara | Emergency Medicine | 8633 N State Road 550, Bruceville, IN 47516-6096 | 2006-03-10 |
| 1427048099 | Mark M Walsh | Emergency Medicine | 801 E Lasalle, Emergency Department, South Bend, IN 46617-2814 | 2005-10-25 |
| Find all providers with the same taxonomy | ||||
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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.