Individual
ALICIA MARIE MIKULSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1 UNIVERSITY AVE, BOURBONNAIS, IL 60914-2345
(815) 928-5415
Mailing address
1356 WINANS AVE APT 3, BOURBONNAIS, IL 60914-4748
(708) 269-5583
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
08/14/2019
Last updated
08/14/2019
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