Individual
DR. JOHN M. VICKERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1290 SHERMER RD, SUITE #3, NORTHBROOK, IL 60062-4567
(847) 480-9141
(847) 480-9143
Mailing address
1439 CORAL PKWY, NORTHBROOK, IL 60062-5192
(847) 480-9141
(847) 480-9143
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
IL
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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