Provider Demographics
NPI:1447093612
Name:QUID, NICOLE KATHLEEN (CPNP-PC, DNP, RNC-OB)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:KATHLEEN
Last Name:QUID
Suffix:
Gender:F
Credentials:CPNP-PC, DNP, RNC-OB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:847-390-5450
Practice Address - Street 1:1775 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1143
Practice Address - Country:US
Practice Address - Phone:847-723-5150
Practice Address - Fax:847-723-2083
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041408813163WX0003X
IL209.030175363L00000X
IL041.408813163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No163W00000XNursing Service ProvidersRegistered Nurse