MRS. STEPHANIE WICKMAN (NPI# 1780052423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780052423 |
| Entity Type | Individual |
| Full Name | MRS. STEPHANIE WICKMAN |
| Credential | APN |
| Practice Address |
3801 W Conestoga Trl Prairie Grove IL 60012-2081 |
| Practice Telephone | 8472090128 |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2015-09-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
209012707 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3801 W CONESTOGA TRL |
| City | PRAIRIE GROVE |
| State | IL |
| Zip Code | 60012-2081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033574629 | Joan M Ryan | Counselor | 610 N Route 31, Suite E, Crystal Lake, IL 60012 | 2015-12-23 |
| 1285972331 | Lauren Elyse Westerman | Physical Therapist | 1000 Brighton Ln, Crystal Lake, IL 60012 | 2013-01-24 |
| 1447537469 | Sean Gale | Pharmacist | 135 Carmella Dr, Crystal Lake, IL 60012 | 2011-11-04 |
| 1477836625 | Judy Meekyung Fakhouri | Pharmacist | 315 N. Route 31, Crystal Lake, IL 60012 | 2011-09-23 |
| 1730462136 | Leslie Dawn Weckerlin | Pharmacist | 315 N Route 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1639452188 | Laura Jean Galles | Pharmacist | 315 N. Routet 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1326320516 | Stacey Jean Knuth | Pharmacist | 315 North Route 31, Crystal Lake, IL 60012 | 2011-09-13 |
| 1356469803 | Donn Orien Humphries | Chiropractor | 690 N Route 31, Suite F, Crystal Lake, IL 60012 | 2007-03-26 |
| 1538204508 | Midwest Physical Therapy Ctr | Clinic/Center | 630 N Rt 31, Suite 103, Crystal Lake, IL 60012 | 2007-02-20 |
| 1356488415 | Charlotte Joy Parcels | Social Worker | 8600 Route 14, Suite 110, Crystal Lake, IL 60012 | 2007-01-30 |
| Find all providers in zip 60012 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851998553 | Melissa Litwin | Nurse Practitioner | 9127 Burlington Ave, Brookfield, IL 60513-1939 | 2020-10-06 |
| 1932724200 | Tatyana Menaker | Nurse Practitioner | 2958 West Devon Ave, Chicago, IL 60659 | 2020-06-12 |
| 1518506625 | Lila Macalinga Rivera | Nurse Practitioner | 17w335 16th St, Oakbrook Terrace, IL 60181-4030 | 2020-01-06 |
| 1922642495 | Christine Nacar | Nurse Practitioner | 1232 Le Moyne Ave, Romeoville, IL 60446-4180 | 2019-10-29 |
| 1144871344 | Wensheng Tracy Wu | Nurse Practitioner | 1555 Barrington Rd Ste 1200, Hoffman Estates, IL 60169-5036 | 2019-09-27 |
| 1881245314 | Mkbb LLC | Nurse Practitioner | 1212 E Algonquin Rd, Algonquin, IL 60102-5446 | 2019-09-25 |
| 1225681455 | Jinu Joss | Nurse Practitioner | 9939 N Warren Oval, Niles, IL 60714-1044 | 2019-07-17 |
| 1659830057 | Ginger Dean | Nurse Practitioner | 2843 Chicago Rd, South Chicago Heights, IL 60411-4736 | 2019-03-15 |
| 1770048910 | Amanda K Honchell I | Nurse Practitioner | 401 W Madison St, Mount Carroll, IL 61053-9485 | 2019-02-01 |
| 1548725799 | Grace Nwaka Wabomnor | Nurse Practitioner | 17 E Grandview Dr, South Holland, IL 60473-1099 | 2019-02-01 |
| Find all providers with the same taxonomy | ||||
| City | PRAIRIE GROVE |
| Zip Code | 60012 |
Please comment or provide details below to improve the information on MRS. STEPHANIE WICKMAN.
| 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.