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1760994404
SARAH RAE WICKENHAUSER
SPRINGFIELD, IL
NPI
1760994404
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209016863)
Enumeration Date
2017-11-03
Last Update Date
2021-12-30
Business Address
SARAH RAE WICKENHAUSER
5220 6TH STREET FRONTAGE RD E
SPRINGFIELD, IL 62703-5735
Phone number: 217-993-0998
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Mailing Address
SARAH RAE WICKENHAUSER
2806 E ANDREW RD
SHERMAN, IL 62684-9517
Phone number: 217-483-1900
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