MEDICARE: ANDREW R DICKHAUT SLP

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	01409	IA
2	235Z00000X	Speech-Language Pathologist	7574	MN

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	46-00669	OTHER	MN	MEDICA
2	066L0DI	OTHER	MN	BLUE CROSS BLUE SHIELD MN
3	46-00668	OTHER	MN	MEDICA
4	46-00667	OTHER	MN	MEDICA
5	1783426	OTHER	MN	ARAZ
6	46-00864	OTHER	MN	MEDICA
7	28975	OTHER	MN	SIOUX VALLEY HEALTH PLANS
8	7736	OTHER	MN	AVERA HEALTH PLANS
9	46-00762	OTHER	MN	MEDICA

NPI Number	:	1386630762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW R DICKHAUT SLP

Provider Business Mailing Address
First Line	:	1720 S CLIFF AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57105-2129
Country	:	US
Telephone Number	:	605-334-5630
Fax Number	:	605-332-5327

Provider Business Practice Location Address
First Line	:	1720 S CLIFF AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57105-2129
Country	:	US
Telephone Number	:	605-334-5630
Fax Number	:	605-332-5327

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	09/11/2025

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1720 S CLIFF AVE
SIOUX FALLS, SD
57105-2129