Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nichole Christine Rave, PA-C

Individual provider Athletic Trainer · NPI 1386031045

Nichole Christine Rave, PA-C is a Physician Assistant in Bloomington, Illinois. Qualified in 2021, 5 years ago. Practices with Associates in Dermatology SC, a 6-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
5
Licensed in
IL
In the registry since
2015
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1404 Eastland Dr Ste 204
Bloomington, IL 61701-7904
Phone: (309) 662-8813
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 085009019 (IL)
Athletic Trainer Taxonomy 2255A2300X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1386031045
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 21, 2015
Last updated in NPPESMay 24, 2024
Certification dateMay 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Associates In Dermatology Sc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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