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Individual

MS. MADISON LAKE-WICKHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1S210 SUMMIT AVE, OAKBROOK TERRACE, IL 60181-3933
(630) 282-6004
Mailing address
1S210 SUMMIT AVE, OAKBROOK TERRACE, IL 60181-3933

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041519145
IL

Other

Enumeration date
05/17/2022
Last updated
05/17/2022
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