Mrs Stephanie Wickman, APN is a
Nurse Practitioner - Adult Health based in Prairie Grove, Illinois. Mrs Stephanie Wickman is licensed to practice in Illinois (license number 209012707) and her current practice location is
3801 W Conestoga Trl, Prairie Grove, Illinois. She can be reached at her office (for appointments etc.) via phone at
(847) 209-0128.
NPI number for Mrs Stephanie Wickman is 1780052423 and her current mailing address is 3801 W Conestoga Trl, Prairie Grove, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1780052423.
Provider's Profile
Full Name | Mrs Stephanie Wickman |
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Gender | Female |
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Speciality | Nurse Practitioner - Adult Health |
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Location | 3801 W Conestoga Trl, Prairie Grove, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1780052423
- Provider Enumeration Date: 09/11/2015
- Last Update Date: 09/11/2015
Medical Identifiers
Medical identifiers for Mrs Stephanie Wickman such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1780052423 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LA2200X | Nurse Practitioner - Adult Health | 209012707 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Stephanie Wickman is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Stephanie Wickman, APN 3801 W Conestoga Trl, Prairie Grove, IL 60012-2081 Ph: () - | Mrs Stephanie Wickman, APN 3801 W Conestoga Trl, Prairie Grove, IL 60012-2081 Ph: (847) 209-0128 |
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