Individual
RICHARD ERICKSON CAPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
8207 22ND AVE, KENOSHA, WI 53143-6206
(262) 653-9286
(224) 610-2601
Mailing address
18608 W MAIN ST, GAGES LAKE, IL 60030-1755
(847) 912-3715
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.117020
IL
Other
Enumeration date
04/13/2023
Last updated
04/13/2023
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