Healthcare Provider Details

I. General information

NPI: 1700054988
Provider Name (Legal Business Name): MRS. ERIKA MARIE WINSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2255 ENTERPRISE DR STE 5501
WESTCHESTER IL
60154-5808
US

IV. Provider business mailing address

8629 ROCKEFELLER AVE
BROOKFIELD IL
60513-1414
US

V. Phone/Fax

Practice location:
  • Phone: 708-863-3803
  • Fax:
Mailing address:
  • Phone: 306-386-0677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: