| Doctor Name: | NICOLE VAN DYCKE |
| NPI Number: | 1083063002 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., CFY-SLP |
| License Number: | 242.003895 |
| Business Practice Address: | 15 Commerce Dr Suite 116 Grayslake, IL - 600307807 |
| Business Phone Number: | 8472237433 |
| Business Fax Number: | |
| Mailing Address: | 7015 Edgewood Ct, SPRING GROVE |
| State: | IL |
| Postal Code: | 600818335 |
| Phone Number: | 8153530068 |
| Fax Number: | |
| NPI Enumeration Date: | 06/09/2016 |
| NPI Last Update Date: | 06/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | 242.003895 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |