Individual
HEATHER MICKELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
918 COUNTRYSIDE DR, WHEATON, IL 60187-3253
(630) 346-8056
Mailing address
918 COUNTRYSIDE DR, WHEATON, IL 60187-3253
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
M24233794734
IL
Other
Enumeration date
11/30/2015
Last updated
11/30/2015
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