Individual
EMILY WICKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP/L
Contact information
Practice address
150 S BLOOMINGDALE RD, SUITE B, BLOOMINGDALE, IL 60108-1493
(630) 351-2941
Mailing address
445 N ELMWOOD AVE, WOOD DALE, IL 60191-1526
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
03/06/2013
Last updated
03/06/2013
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