Individual
DEBRA F NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1N141 COUNTY FARM RD, SUITE 130, WINFIELD, IL 60190-2032
(630) 752-9725
(630) 752-9726
Mailing address
PO BOX 239, WINFIELD, IL 60190-0239
(630) 752-9725
(630) 752-9726
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071006202
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCBS
022-32734
IL
Enumeration date
04/13/2007
Last updated
03/06/2009
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