Healthcare Provider Details

I. General information

NPI: 1841090610
Provider Name (Legal Business Name): MEHGAN RICKETT CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S RANDALL RD STE 220
ALGONQUIN IL
60102-5937
US

IV. Provider business mailing address

1810 DORCHESTER AVE
ALGONQUIN IL
60102-5195
US

V. Phone/Fax

Practice location:
  • Phone: 847-854-9402
  • Fax:
Mailing address:
  • Phone: 847-754-7644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number209031958
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: