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Individual
ANDREA IKEDA
Active
Individual
ANDREA IKEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., C.P., L.P.
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09932112
BCBS
IL
05
—
113671669001
—
IL
Enumeration date
05/25/2006
Last updated
07/13/2026
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