Individual
JOHN CHU HICKERNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(888) 584-7888
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.171932
IL
207RR0500X
Rheumatology Physician
Primary
036.171932
IL
Other
Enumeration date
03/21/2022
Last updated
04/15/2025
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