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1245533264
KATHLEEN PATRICIA MICKOW
EVANSTON, IL
NPI
1245533264
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209.008533)
Enumeration Date
2010-12-13
Last Update Date
2019-10-25
Business Address
Ms. KATHLEEN PATRICIA MICKOW FNP-BC
1942 DEMPSTER ST
EVANSTON, IL 60202-1016
Phone number: 847-869-6315
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Mailing Address
Ms. KATHLEEN PATRICIA MICKOW FNP-BC
205 SHEFFIELD LN
VERNON HILLS, IL 60061-2929
Phone number: 630-857-6014
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