Individual
CAROL S HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
119 GAS PLANT RD, DU QUOIN, IL 62832-3866
(618) 542-8702
Mailing address
PO BOX 155, CHRISTOPHER, IL 62822-0155
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043030743
IL
Other
Enumeration date
09/12/2008
Last updated
09/12/2008
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