| Doctor Name: | DR. NICOLE PACHECO |
| NPI Number: | 1265767941 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 071007442 |
| Business Practice Address: | 1600 S 4th Ave Suite 140 Morton, IL - 615502889 |
| Business Phone Number: | 3098682495 |
| Business Fax Number: | |
| Mailing Address: | Po Box 995, MORTON |
| State: | IL |
| Postal Code: | 615500995 |
| Phone Number: | 3098682495 |
| Fax Number: | |
| NPI Enumeration Date: | 10/13/2009 |
| NPI Last Update Date: | 07/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 071007442 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |