NICOLE E BACK

CHICAGO, IL
NPI1134672116
Other NameNICOLE E GENTRY
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085005861)
Enumeration Date2016-07-26
Last Update Date2024-10-23
Business Address
NICOLE E BACK PA-C
5841 S MARYLAND AVE
CHICAGO, IL 60637-1443
Phone number: 888-824-0200
Mailing Address
NICOLE E BACK PA-C
150 HARVESTER DR SUITE 300
BURR RIDGE, IL 60527-5919
Phone number:
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