Individual
MRS. KATHRYN LISA HICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
944 LANDON AVE, WINTHROP HARBOR, IL 60096-1732
(847) 501-0620
Mailing address
944 LANDON AVE, WINTHROP HARBOR, IL 60096-1732
(847) 501-0620
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.001443
IL
Other
Enumeration date
04/02/2012
Last updated
04/03/2012
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