AMBER ELISE VICIC (NPI# 1871090225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871090225 |
| Entity Type | Individual |
| Full Name | AMBER ELISE VICIC |
| Practice Address |
704 Maplewood Dr Minooka IL 60447-1234 |
| Practice Telephone | 8158784835 |
| Mailing Telephone | 8158784835 |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-04-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
704 MAPLEWOOD DR |
| City | MINOOKA |
| State | IL |
| Zip Code | 60447-1234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326538596 | Wanda Hardy Perkins | Social Worker | 203 W Mondamin St, Minooka, IL 60447 | 2018-05-14 |
| 1629597729 | Jennifer Praveen | Psychologist | 333 Mcevilly Rd, Minooka, IL 60447 | 2017-09-11 |
| 1013164193 | Carrie Ann Skubic | Counselor | 113 W. Wapella St., Suite 2, Minooka, IL 60447 | 2008-08-20 |
| 1164624680 | Minooka Comm Hs Dist 111 | Local Education Agency (LEA) | 203 W Mondamin, Minooka, IL 60447 | 2007-06-05 |
| 1710196191 | Ridge Dental Group, Ltd | Dentist | 2003 Ridge Road, Minooka, IL 60447 | 2007-05-22 |
| 1629109020 | James Dale Mcgehee | Dentist | 123 Mondamin Street, Minooka, IL 60447 | 2007-03-08 |
| 1073554341 | Minooka Fire Protection District | Ambulance | 413 W Mondamin, Minooka, IL 60447 | 2006-06-09 |
| 1639110612 | Angela Solis | Counselor | 113 West Wapella Street, Suite 2, Minooka, IL 60447 | 2006-06-09 |
| 1811944366 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 2051 Ridge Rd, Minooka, IL 60447 | 2006-05-30 |
| 1427205111 | Crossroads Counseling Services, LLC | Counselor | 113 W. Wapella St., Suite 2, Minooka, IL 60447 | 2008-08-25 |
| Find all providers in zip 60447 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053951533 | Stephanie Paige Greene | Student in an Organized Health Care Education/Training Program | 305 W Church St, Minooka, IL 60447-9585 | 2020-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720436 | April Renee Gallik | Student in an Organized Health Care Education/Training Program | 8807 S 79th Ave Apt 18, Hickory Hills, IL 60457-1597 | 2020-11-03 |
| 1932709706 | Samantha Klosak | Student in an Organized Health Care Education/Training Program | 8144 Old Mill Rd, Frankfort, IL 60423-8675 | 2020-10-29 |
| 1508466624 | Carly Belle Mitchell | Student in an Organized Health Care Education/Training Program | 870 Appletree Ct, Northbrook, IL 60062-3402 | 2020-10-28 |
| 1144829813 | Payton Collins | Student in an Organized Health Care Education/Training Program | 5103 S Brookstone Dr, Rochelle, IL 61068-9131 | 2020-10-22 |
| 1821697830 | Mayuri Prashant Shende | Student in an Organized Health Care Education/Training Program | 2160 S. First Ave., Bldg. 105, Suite 2840a, Marywood, IL 60135 | 2020-10-21 |
| 1922607001 | Katherine Chen | Student in an Organized Health Care Education/Training Program | 2305 Mohawk Ln, Glenview, IL 60026-1035 | 2020-10-20 |
| 1922606995 | Cassia Yuechun Weigel | Student in an Organized Health Care Education/Training Program | 601 N Main St Apt 5s, Normal, IL 61761-1576 | 2020-10-13 |
| 1679171888 | Manuel J Ramirez | Student in an Organized Health Care Education/Training Program | 714 W Woodland Rd, Lake Bluff, IL 60044-1652 | 2020-10-12 |
| 1205443975 | Nickolas Armstrong | Student in an Organized Health Care Education/Training Program | 2828 N Pine Grove Ave Apt 618, Chicago, IL 60657-6137 | 2020-09-28 |
| 1871109496 | Morgan Elizabeth Westjohn | Student in an Organized Health Care Education/Training Program | 111 Mound St, Sainte Marie, IL 62459 | 2020-09-18 |
| 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.