Healthcare Provider Details

I. General information

NPI: 1508799982
Provider Name (Legal Business Name): AMAURI MONAE HICKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5540 W 111TH ST
OAK LAWN IL
60453-5574
US

IV. Provider business mailing address

9901 S MAPLEWOOD AVE
CHICAGO IL
60655-1057
US

V. Phone/Fax

Practice location:
  • Phone: 708-513-0329
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: