Organization
NICKERSON & ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA NICKERSON PSY.D. (PRESIDENT)
(630) 752-9725
Entity
Organization
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
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022-32734
BCBS GROUP NUMBER
—
Enumeration date
01/31/2007
Last updated
03/06/2009
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