Individual
DR. LIDIA B ICKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
55 S MAIN ST, SUITE 241, NAPERVILLE, IL 60540-5372
(630) 848-2010
Mailing address
PO BOX 221360, CHICAGO, IL 60622-0057
(248) 245-0903
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.028229
IL
1223G0001X
General Practice Dentistry
2901019598
MI
1223G0001X
General Practice Dentistry
DN 18015
FL
Other
Enumeration date
09/07/2007
Last updated
04/04/2011
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