Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | R8N53 | MO |
Y | 2084N0402X | Child Neurologist | R8N53 | MO |
NPI | 1083622955 |
---|---|
Provider Name | Alma R Bicknese |
First Address | Chicago, IL 60612-4325 |
Second Address | Chicago, IL 60612-4795 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 05/12/2011 |