Dr. Eric Owen Nicholls, OD
Optometrist in Johnsburg, IL. Individual provider (NPI-1).
NPI number1821189051
StatusActive
Last updated in NPPESOct 5, 2016
Details
- NPI
- 1821189051
- Entity type
- Individual (NPI-1)
- Name
- Dr. Eric Owen Nicholls
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 26, 2006
- Last updated
- Oct 5, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 46009345 | IL | Yes |
| 152WC0802X | Optometrist, Corneal and Contact Management | 46009345 | IL |
Practice location
3801 Running Brook Farm BlvdJohnsburg, IL 60051-5425
Phone 815-385-9224
Mailing address
35298 N Sheridan DrIngleside, IL 60041-8760
Phone 847-858-6748
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