National Provider Identifier Database

NICHELL TIDWELL, MD – NPI #1740200765
Pediatric Emergency Medicine

Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department.


Contact Information

NICHELL TIDWELL, MD
225 E CHICAGO AVE
CHICAGO, IL60611-2991
Phone: 800-543-7362
Fax:
Website:
Specialty Taxonomy Code
* Pediatric Emergency Medicine 207PP0204X
Emergency Medicine 207P00000X

* Indicates primary specialty

NPI Profile & details for NICHELL TIDWELL

NPI Number 1740200765
Credentials MD
Entity Individual
Enumeration date 07/20/2006
Last updated 04/29/2020 - About 6 years ago
Sole proprietor1 No
Identifiers
  • IL License #: 036086376
  • IL Medicaid: 036086376
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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