Individual
ERIC ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2748 CATON FARM RD, JOLIET, IL 60435-1309
(815) 609-0554
Mailing address
12400 S HARLEM AVE, PALOS HEIGHTS, IL 60463-1440
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01622333
BLUE CROSS BLUE SHIELD
IL
01
—
7454077
AETNA
IL
Enumeration date
11/21/2007
Last updated
11/21/2007
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