MEDICARE: MICKI RING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1821967589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICKI RING

Provider Business Mailing Address
First Line	:	2045 W GRANDE AVE
Second Line	:	STR B PMB 37767
City	:	CHICAGO
State	:	IL
Zip	:	60612
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2045 W GRAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-1576
Country	:	US
Telephone Number	:	800-827-7437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2025
Last Update Date	:	11/07/2025

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Directions to “ MICKI RING ” Practice Location

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