DR. PETER WARNER JR. NICHOLS (MD) – Child & Adolescent Psychiatry Physician, NPI 1013112143

DR. PETER WARNER JR. NICHOLS (MD) is a healthcare provider. based in Chicago, Illinois. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. 036.118548 (IL). The NPI Number for DR. PETER WARNER JR. NICHOLS (MD) is 1013112143

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
DR. PETER WARNER JR. NICHOLS (MD)
NPI
1013112143
Phone
(626) 253-0786
Address
904 W DIVERSEY PKWY APT 2W
Enumeration Date
19 June 2007
Last Update Date
16 November 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7738789700
Graduation Year
2004 (22 years ago)
PAC ID
1759690811
Group Practice PAC ID
4284021262
Professional Enrollment ID
I20151013000290
Address ID
IL606405122CH4720XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

1,367 PSYCHIATRY in IL

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Provider Addresses for DR. PETER WARNER JR. NICHOLS (MD)

  • 904 W DIVERSEY PKWY APT 2W

    CHICAGO, IL 606141468

    Phone: (626) 253-0786

    Type: Mailing

  • East Irving Park Road, Hanover Park, Streamwood, Hanover Township, Cook County, Illinois, 60107, United States

    STREAMWOOD, IL 601073201

    Phone: (630) 837-9000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $28.

Total Amount is formed as General ($28) + Research ($0) + Ownership ($0) = $28.

Last reported payment date: 2023-11-27 • Largest payer in this snapshot: ABBVIE INC. ($28).

Total Amount

$28

General + Research + Ownership

Payments

1

Total payment records

General Amount

$28

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-27

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$28
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-10-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20151013000290IPsychiatryILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60614)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4284021262View full group profile
NameSpecialtyState
Nurse PractitionerIL
P S Y C H I A T R YIL
P S Y C H I A T R YIL

Reviews

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Frequently asked questions

How is DR. PETER WARNER JR. NICHOLS (MD) identified in CMS data?
CMS-hosted NPPES data lists DR. PETER WARNER JR. NICHOLS (MD) with NPI 1013112143.
Does CMS list DR. PETER WARNER JR. NICHOLS (MD) as active?
Yes — DR. PETER WARNER JR. NICHOLS (MD) is active in the NPI listing used on this page.
What healthcare role does DR. PETER WARNER JR. NICHOLS (MD) hold?
Scheduling teams often label DR. PETER WARNER JR. NICHOLS (MD) under Child & Adolescent Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Does DR. PETER WARNER JR. NICHOLS (MD) list a practice location?
Patients near Chicago, Illinois may find DR. PETER WARNER JR. NICHOLS (MD) in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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