Nicole Kennebeck, PA-C
Physician Assistant in Chicago, IL. Individual provider (NPI-1).
NPI number1013680321
StatusActive
Last updated in NPPESFeb 9, 2026
Details
- NPI
- 1013680321
- Entity type
- Individual (NPI-1)
- Name
- Nicole Kennebeck
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 1, 2021
- Certification date
- Feb 9, 2026
- Last updated
- Feb 9, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085008879 | IL | Yes |
Other names
- Nicole Borkowski (Other Name)
Practice location
251 E Huron St Fl 14Chicago, IL 60611-2908
Phone 312-926-9843 · Fax 312-926-8119
Mailing address
251 E Huron St Fl 14Chicago, IL 60611-2908
Phone 312-926-9843 · Fax 312-926-8119
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