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General NPI Number Information
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NPI Number | 1306420351
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Entity Type | Individual
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Provider Name | DENICE SYKES
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Gender | Female
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Dates
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Enumeration Date | 05/06/2021
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 401 W LAKE ST
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City | NORTHLAKE
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State | IL
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Zip | 60164-2435
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Country | US
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Telephone | 855-477-5627
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Fax |
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Provider Business Mailing Address
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Address Line | 221 30TH AVE
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City | BELLWOOD
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State | IL
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Zip | 60104-1893
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Country | US
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Telephone | 810-391-8713
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Fax | 800-549-7485
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 057.004962
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License Number State | IL
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