Individual
MS. KATHLEEN PATRICIA MICKOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1942 DEMPSTER ST, EVANSTON, IL 60202-1016
(847) 869-6315
Mailing address
205 SHEFFIELD LN, VERNON HILLS, IL 60061-2929
(630) 857-6014
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.008533
IL
Other
Enumeration date
12/13/2010
Last updated
10/25/2019
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