NICOLE MEDINA LSW NPI 1063392256

NPI Information

  • NPI: 1063392256
  • Provider Name: NICOLE MEDINA, LSW
  • Classification: Social Worker - 104100000X
  • Entity Type: Individual
  • Address: 1800 HOLLISTER DR STE 201
    LIBERTYVILLE, IL
    ZIP 60048
  • Phone: (847) 549-1189

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NPI Details

Nicole Medina, LSW is a social worker in Libertyville, IL. The provider is a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. Nicole Medina, LSW NPI is 1063392256. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1800 HOLLISTER DR STE 201
LIBERTYVILLE, IL
ZIP 60048-266
Phone: (847) 549-1189

The enumeration date for this NPI number is 9/6/2025 and was last updated on 9/6/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1104100000XSocial Worker150.116992ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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