Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
NICHOLAS R IDLE, PA
ActiveNICHOLAS R IDLE, PA is a Physician Assistant healthcare provider located in URBANA, Illinois. NPI 1467738005 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · URBANA, IL
Registration Details
- NPI Number
- 1467738005
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 27, 2011 (14.778291441324 yrs)
- Last Updated
- Feb 3, 2016
- Licenses
-
085004157 (IL)085.004157 (IL)
Practice Information
- Address
-
611 W. PARK ST.HVIURBANA, IL, 618012500Browse IL providers · Browse ZIP 61801
- Phone
- 2179047000
- Fax
- 2179047742
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Surgical Physician Assistant
Other Physician Assistant Providers in URBANA, IL
| Name | Credential | NPI |
|---|---|---|
| RICHARD OFFENBACK JR. | PA | 1871584920 |
| THOMAS MCCALL | PA-C | 1639148257 |
| TERI D WEIR | PA | 1679598031 |
| ERIC KUCHEFSKI | PA | 1194895821 |
| HOSHANG IRANI | PA | 1033270954 |
| JAMES S PHARES | PA | 1659417293 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.