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Nicole M Chickris-bollaert, MD
Student in an Organized Health Care Education/Training Program in Moline, Illinois
NPI 1922329507

Nicole M Chickris-bollaert is a Student in an Organized Health Care Education/Training Program based in Moline, IL. Nicole M Chickris-bollaert practices in Moline, IL and has the professional credentials of MD. The NPI Number for Nicole M Chickris-bollaert is 1922329507 and holds a License No. 036.130996 (Illinois).

The current practice location address for Nicole M Chickris-bollaert is 5401 44Th Avenue Dr Ste 101, Moline, IL and can be reached out via phone at 309-779-4050.

Location: 5401 44Th Avenue Dr Ste 101, Moline, IL, 61265-6138
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1922329507
Provider Name
Nicole M Chickris-bollaert
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
5401 44Th Avenue Dr Ste 101, Moline, IL, 61265-6138
Phone Number
309-779-4050
Fax Number
Provider Enumeration Date
06/17/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1922329507 05 IL
036130996 05 IL
institution
Provider Business Practice Location Address Details
Address
5401 44Th Avenue Dr Ste 101
City
Moline
State
Illinois
Zip
61265-8126
Phone Number
309-779-4050
Fax Number
person
Provider Business Mailing Address Details
Address
5401 44Th Avenue Dr Ste 101
City
Moline
State
Illinois
Zip
61265-8126
Phone Number
309-779-4050
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
125058663 (Illinois)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
036.130996 (Illinois)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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