Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 036.123528 | IL |
NPI | 1063659001 |
---|---|
Provider Name | Dr. Sara Dickie |
First Address | Skokie, IL 60077-1384 |
Second Address | Skokie, IL 60077-1384 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2009 |
Last Update Date | 07/12/2018 |