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Provider Information for 1154944452


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ASHLEY SPICKLER


Sex: Female

NPI: 1154944452
Last Updated: 2020-05-20
Certification Date: 2020-05-20

Details

NameValue
NPI1154944452
Enumeration Date2020-05-20
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 175 E HAWTHORN PKWY STE 235
VERNON HILLS, IL 60061-1454
United States

Phone: 847-868-3435 | Fax:847-859-5885
 
Primary Practice Address 4615 E STATE ST STE 202
ROCKFORD, IL 61108-2158
United States

Phone: 847-868-3435 | Fax:847-859-5885
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalIL178.014697