MR. MIKE J HICKEY (NPI# 1174729487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174729487 |
| Entity Type | Individual |
| Full Name | MR. MIKE J HICKEY |
| Credential | ATC,CSCS |
| Practice Address |
1415 W Lake St Addison IL 60101-1870 |
| Mailing Address |
1355 Cunat Ct Apt 1b Lake In The Hills IL 60156-6159 |
| Practice Telephone | 6307051950 |
| Practice Fax Number | 6307051980 |
| Mailing Telephone | 7083084734 |
| Enumeration Date | 2007-06-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1415 W LAKE ST |
| City | ADDISON |
| State | IL |
| Zip Code | 60101-1870 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174551162 | Marzena D Kaniuk | Physical Therapist | 1415 W Lake St, Addison, IL 60101 | 2006-06-29 |
| 1588972616 | Premier Medical Care Addison, Ltd | General Practice | 1415 W Lake St, Addison, IL 60101-1870 | 2010-09-23 |
| 1427241884 | Paulina Lowkis | Dietitian, Registered | 1415 W Lake St, Addison, IL 60101-1870 | 2007-08-20 |
| 1881626570 | Charles Baum | Internal Medicine | 1415 W Lake St, Addison, IL 60101-1870 | 2006-07-06 |
| 1013946896 | Sheila Dowd | Psychologist | 1415 W Lake St, Addison, IL 60101-1870 | 2006-07-02 |
| 1376571026 | Renato M Arias | Family Medicine | 1415 W Lake St, Addison, IL 60101-1870 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912445800 | Allure Skin and Laser | Nurse Practitioner | 240 E Lake Street, Addison, IL 60101 | 2017-02-10 |
| 1912444662 | Iulia Kaulinite | Registered Nurse | 1845 East Army Trail Road, Addison, IL 60101 | 2017-01-19 |
| 1164891727 | Sonic Imaging Inc | Clinic/Center | 4n277 9th Ave, Addison, IL 60101 | 2015-09-24 |
| 1881001147 | Evelina Rodriguez | Interpreter | 102 S. Grant Drive, Addison, IL 60101 | 2014-07-18 |
| 1821426867 | Carrie Lyne M Mathiesen | Physical Medicine & Rehabilitation | 2375 S. Randall Rd, Algonquin, IL 60101 | 2013-10-30 |
| 1972949634 | Vascular Diagnostic LLC | Clinic/Center | 2166, W Silverleaf Ln, Addison, IL 60101 | 2013-05-21 |
| 1134401409 | Colleen Ann O'brien | Occupational Therapist | 222 North Kennedy Dr., Addison, IL 60101 | 2011-09-13 |
| 1962700096 | Pharma Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 970 Lake St Suite 109, Roselle, IL 60101 | 2011-03-15 |
| 1235372947 | Nancy M Ngo | Dentist | 200 W. Lake Street, Addison, IL 60101 | 2009-04-10 |
| 1326288275 | Familia Dental | Dentist | 200 West Lake Street, Addison, IL 60101 | 2009-03-04 |
| Find all providers in zip 60101 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316507973 | Bethany Jean Fitzgerald | Specialist/Technologist | 143 Grandview Ln, Addison, VT 05491-8407 | 2019-06-17 |
| 1366001216 | Tea Kiefer | Specialist/Technologist | 7619 Vermont Route 22a, Addison, VT 05491-8924 | 2019-06-12 |
| 1407243983 | Sunie Amerlan | Specialist/Technologist | 208 S Iowa Ave, Addison, IL 60101-3821 | 2015-04-22 |
| 1932239977 | Joshua A. Brooks | Specialist/Technologist | 17200 Westgrove Dr, Apt. 522, Addison, TX 75001-7122 | 2007-03-07 |
| 1093858797 | Russell Arthur Betts | Specialist/Technologist | 17001 Addison Rd, Addison, TX 75001-5027 | 2007-02-14 |
| 1326008376 | Jeffery Kent Johnson | Specialist/Technologist | 4141 Spring Valley Rd, Addison, TX 75001-3615 | 2006-03-24 |
| 1609411446 | Kaitlynn Elizabeth Rios | Specialist/Technologist | 17001 Addison Rd, Addison, TX 75001-5096 | 2019-11-15 |
| 1184128951 | Jeannette Utterback | Specialist/Technologist | 17001 Addison Rd, Addison, TX 75001-5096 | 2018-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538771076 | Stacey Weathers-cannon | Specialist/Technologist | 650 Ingraham Ave, Calumet City, IL 60409-4236 | 2020-08-17 |
| 1104438621 | Abril Malagon | Specialist/Technologist | 1 S Greenwood Ave, Palatine, IL 60074-6328 | 2020-08-17 |
| 1265050678 | Megan Elsbree | Specialist/Technologist | 11819 Deacon Dr, Rockton, IL 61072-9411 | 2020-07-13 |
| 1013534437 | Nicole Rose Mondelli | Specialist/Technologist | 958 Tallgrass Dr, Bartlett, IL 60103-5071 | 2020-07-01 |
| 1740806413 | Megan Herter | Specialist/Technologist | 1513 Old Ivy Dr, Springfield, IL 62711-8156 | 2020-06-18 |
| 1164047239 | Madison Stagman | Specialist/Technologist | 280 Douglas Ave Apt 4, Mascoutah, IL 62258-2963 | 2020-06-14 |
| 1588286272 | Sarah Wegrzyn | Specialist/Technologist | 3040 S Wabash Ave, Chicago, IL 60616-3474 | 2020-05-15 |
| 1336761386 | Christine Louise Shebelski | Specialist/Technologist | 15203 Pulaski Rd, Midlothian, IL 60445-3755 | 2020-05-13 |
| 1386266633 | Kathryn Riordan | Specialist/Technologist | 221 Triton Ln, Naperville, IL 60540-7926 | 2020-05-09 |
| 1487276747 | Vianey Hernandez-ramirez | Specialist/Technologist | 4115 Howard St, Skokie, IL 60076-3749 | 2020-05-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.