Sara Jeannine Gale Hicks, LPN
Individual provider Active NPI Licensed Practical Nurse · Du Quoin, IL
NPI 1609025253 · NPPES record last updated Sep 18, 2008
Key facts
- NPI
- 1609025253
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 043101095 (IL)
- Practice address
- 119 Gas Plant Rd
Du Quoin, IL 62832-3866 - Phone
- (618) 542-8702
- NPI assigned
- Sep 18, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043101095 | IL | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 043101095 | IL | Yes |
Addresses
Primary practice location
119 Gas Plant Rd
Du Quoin, IL 62832-3866
Mailing address
PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2436
Other names
- Sara Jeannine Gale
Other providers in Du Quoin, IL
- Robert Erhardt Heisner II
- Adriane Marie Helmer
- Adam Jordan Henson
- Kurt Hermann
- Carol S Hicks
- Debbie S Hill
- Elisabeth Hill
- Jacob Hill
- Wanda Hill
- Ramona Hobbs
All providers in Du Quoin, IL · Licensed Practical Nurse in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.