ANDREA IKEDA, M.S., C.P., L.P., Prosthetist JOLIET, IL

Contact Information

ANDREA IKEDA, M.S., C.P., L.P.

815 N LARKIN AVE
STE. 207
JOLIET, IL 60435-3438

Phone: 815-207-4200
Fax: 815-207-4100
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Prosthetist	224P00000X	56	Individual Certified Prosthetist

Indicates primary specialty

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NPI Profile & details for ANDREA IKEDA · (Female)

NPI Number	`1902852940`
Status	Active
Credentials	M.S., C.P., L.P.
Entity	Individual
Enumeration date	05/25/2006
Last updated	07/08/2007 - About 19 years ago
Sole proprietor ¹	Not specified
Identifiers	IL Medicaid 113671669001 IL Other 09932112 BCBS
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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ANDREA IKEDA, M.S., C.P., L.P. – NPI #1902852940Prosthetist

Contact Information

Specialty

Prosthetist

NPI Profile & details for ANDREA IKEDA · (Female)

Reviews for ANDREA IKEDA

ANDREA IKEDA, M.S., C.P., L.P. – NPI #1902852940
Prosthetist