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Contact Information

JEFFREY J HICKS DPM PC
15 TOWER CT
STE 250
GURNEE, IL60031
 Phone: 847-336-3020
 Fax: 847-336-3318
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JEFFREY J HICKS DPM PC

NPI Number 1588644892
LBN Legal business name JEFFREY J HICKS DPM PC
Authorized official JEFFREY HICKS - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 01/20/2006
Last updated 01/04/2011 - About 15 years ago
Identifiers
IL License # 016004968
IL Medicaid 016004968
IL Other 04926843 BCBS
IL Other 4481570001 NATIONAL GOVERNMENT SERVICES
IL Other DD4677 RAILROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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