Philip Ray Nickols

Athletic Trainer · Macomb, IL

Individual Active NPI

NPI number 1407370729

Practice location

1 University Cir
Macomb, IL 61455
Phone
(309) 298-2138

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NPI record

NPI
1407370729
Entity type
Individual (Type 1)
Enumeration date
July 28, 2017
Last updated
July 21, 2022
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Athletic Trainer Primary 2255A2300X 096.003810 IL

Mailing address

1 University Cir
Macomb, IL 61455-1367
Phone
(309) 298-2138

About Philip Nickols

Philip Ray Nickols is a healthcare provider registered in the NPI registry with the primary taxonomy Athletic Trainer (code 2255A2300X). The practice location is 1 University Cir, Macomb, IL 61455. The NPI number 1407370729 was assigned on July 28, 2017 and the record was last updated on July 21, 2022.

Philip Nickols lists a license in the registry: #096.003810 (IL) for Athletic Trainer. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Philip Ray Nickols?

The NPI number is 1407370729.

What is the phone number of Philip Nickols?

The phone number listed for the practice location is (309) 298-2138.

Where is Philip Nickols located?

1 University Cir, Macomb, IL 61455.

What is the taxonomy code for Philip Nickols?

The primary taxonomy code is 2255A2300X – Athletic Trainer.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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