Individual ProviderNicole Nola RousonelosAcupuncturistOther Service ProvidersPractice Address1339 W Devon Ave, Chicago, IL 60660-1329(773) 293-7642(815) 955-3591PECOS EnrollmentBased on the most recent information from CMS, provider Nicole Nola Rousonelos does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1881448603Provider TypeIndividualFull NameRousonelos, Nicole NolaTitleDr.CredentialDACGenderFemaleSole ProprietorYesEnumeration Date4/17/2024Last Updated4/17/2024Contact InformationPractice LocationPractice Address1339 W Devon Ave, Chicago, IL 60660-1329Phone(773) 293-7642FaxUnlisted FaxMailing LocationMailing Address4535 N Paulina St Apt 2d, Chicago, IL 60640-5326Phone(815) 955-3591FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171100000XPrimaryDescriptionAcupuncturistOther Service ProvidersLicense198.001651Illinois