Doctor Name: | MS. NICOLE C PENDLETON |
NPI Number: | 1548697840 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | 227015868 |
Business Practice Address: | 1821 W Belmont Ave Chicago, IL - 606572040 |
Business Phone Number: | 7738633800 |
Business Fax Number: | |
Mailing Address: | 2012 N Howe St, 3n CHICAGO |
State: | IL |
Postal Code: | 606144414 |
Phone Number: | 7736822313 |
Fax Number: | |
NPI Enumeration Date: | 10/01/2013 |
NPI Last Update Date: | 10/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 227015868 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |