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Contact Information

ILA M MINNICK
7604 BRIDLEWOOD RD
CALEDONIA, IL61011-9013
 Phone: 815-885-1195
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Administrator

163WA2000X
Indicates primary specialty

NPI Profile & details for ILA M MINNICK · (Female)

NPI # 1134240989
Status Active
Credentials
Entity Individual
Enumeration date 04/02/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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