Individual
DR. MICHAEL J KIKTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1728 RED OAK LN, ROCKFORD, IL 61107-2763
(815) 227-1068
Mailing address
1728 RED OAK LN, ROCKFORD, IL 61107-2763
(815) 227-1068
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
036067268
IL
2086S0129X
Vascular Surgery Physician
Primary
036067268
IL
2086S0129X
Vascular Surgery Physician
66280
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036067268 2
—
IL
01
—
194341
PERSONAL CARE
IL
01
—
204575400
OWCP
IL
Enumeration date
06/23/2005
Last updated
07/05/2022
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