Individual
DR. TERESA MICHELLE KIKUGAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DAT, LAT, ATC
Contact information
Practice address
633 EMERSON ST, EVANSTON, IL 60208-0844
(847) 467-5415
(847) 491-2120
Mailing address
645 HIBBARD RD, WILMETTE, IL 60091-2042
(360) 701-3449
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004699
IL
Other
Enumeration date
10/25/2018
Last updated
10/25/2018
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