MEDICARE: JOANNA ICKIS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	06005486A	IN

General Provider Information

NPI Number	:	1578910436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA ICKIS

Provider Business Mailing Address
First Line	:	900 RAND RD STE 300
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-2359
Country	:	US
Telephone Number	:	847-324-3976
Fax Number	:	847-929-1154

Provider Business Practice Location Address
First Line	:	10110 DON S POWERS DR STE 101B
Second Line	:
City	:	MUNSTER
State	:	IN
Zip	:	46321-4070
Country	:	US
Telephone Number	:	219-961-9503
Fax Number	:	219-961-9506

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

Provider Enumeration Date	:	05/20/2016
Last Update Date	:	08/25/2022

Similar Medicare Providers

1093683880 — MRS. GABRIELA SWIIS FNP-C
Practice Location Address:

10110 DONALD S POWERS DR STE 202
MUNSTER, IN
46321-4070

Practice Phone: 219-922-8222
Practice Fax: 219-922-8377

1083673552 — JAMES N DREYFUS MD
Practice Location Address:

10110 DON S POWERS DR STE 101D
MUNSTER, IN
46321-4070

Practice Phone: 219-670-4421
Practice Fax:

1467688879 — CARLOS RAFAEL GONZALEZ RENDON M.D.
Practice Location Address:

10110 DON S POWERS DR STE 202
MUNSTER, IN
46321-4070

Practice Phone: 219-922-8222
Practice Fax:

1669835963 — MR. TAYLOR DRAKE COLEMAN I MD
Practice Location Address:

10110 DONALD S POWERS DR STE 202
MUNSTER, IN
46321-4070

Practice Phone: 219-922-8222
Practice Fax: 219-922-8899

1841722717 — IMRAN AHMAD MD
Practice Location Address:

10110 DONALD S POWERS DR STE 202
MUNSTER, IN
46321-4070

Practice Phone: 219-922-8222
Practice Fax: 219-922-8377

1457932337 — DR. MICHAEL JENNINGS LANE SR. DNP PMHNP-BC
Practice Location Address:

10110 DONALD S POWERS DR STE 101C
MUNSTER, IN
46321-4070

Practice Phone: 269-250-8013
Practice Fax: 877-326-2856

Directions to “ JOANNA ICKIS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.