Individual
TAMYRA HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
114 N MARION ST STE 206, OAK PARK, IL 60301-1005
(224) 477-3796
Mailing address
1808 GROVE AVE APT 1, BERWYN, IL 60402-5644
(773) 969-1793
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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