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Contact Information

NICHELL TIDWELL, MD
225 E CHICAGO AVE
CHICAGO, IL60611-2991
 Phone: 800-543-7362
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Emergency Medicine

207PP0204X 93 Physician/Emergency Medicine
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for NICHELL TIDWELL · (Female)

NPI Number 1740200765
Status Active
Credentials MD
Entity Individual
Enumeration date 07/20/2006
Last updated 04/29/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036086376
  • IL Medicaid 036086376
Hospital affiliation(s) Not Available
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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