Individual provider · NPI-1

Nicole Marie Chum, FNP-BC

Nurse Practitioner, Family · Peru, IL

NPI number1699402016
StatusActive
Last updated in NPPESAug 5, 2022

Details

NPI
1699402016
Entity type
Individual (NPI-1)
Name
Nicole Marie Chum
Credential
FNP-BC
Sex
Female
Sole proprietor
No
Enumeration date
Aug 5, 2022
Certification date
Aug 3, 2022
Last updated
Aug 5, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family209.025606ILYes

Practice location

920 West St Ste 216
Peru, IL 61354-2769

Phone 309-451-3376 · Fax 309-452-3376

Mailing address

1986 N 2919th Rd
Marseilles, IL 61341-9002

Phone 815-343-4494

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