Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole E Back, PA-C

Individual provider Physician Assistant · NPI 1134672116

Nicole E Back, PA-C is a Physician Assistant in Chicago, Illinois. Qualified in 2016, 10 years ago. Practices with Northwestern Medical Faculty Foundation, a 4,394-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
10
Licensed in
IL
In the registry since
2016
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

675 N Saint Clair St Ste 21-100
Chicago, IL 60611-5970
Phone: (312) 695-0990
Fax: (312) 695-1106
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085005861 (IL)

Record details

NPI number1134672116
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 26, 2016
Last updated in NPPESOctober 30, 2025
Certification dateOctober 30, 2025
Mailing address675 N Saint Clair St Ste 21-100, Chicago, IL 60611-5970

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Northwestern Medical Faculty Foundation — 4394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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