Individual
FOTINI WICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
950 N YORK RD, SUITE 109, HINSDALE, IL 60521-2950
(630) 654-1391
(630) 654-1967
Mailing address
950 N YORK RD, SUITE 109, HINSDALE, IL 60521-2950
(630) 654-1391
(630) 654-1967
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147001186
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
399980
MEDICARE GROUP PTAN
IL
Enumeration date
10/02/2013
Last updated
01/29/2015
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