Provider Demographics
NPI:1821213075
Name:MIKOS, HELEN BARBARA (DEVELOPMENTAL THERAP)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:BARBARA
Last Name:MIKOS
Suffix:
Gender:F
Credentials:DEVELOPMENTAL THERAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3949 KEENEY ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3354
Mailing Address - Country:US
Mailing Address - Phone:847-674-0801
Mailing Address - Fax:847-674-0801
Practice Address - Street 1:3949 KEENEY ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-3354
Practice Address - Country:US
Practice Address - Phone:847-674-0801
Practice Address - Fax:847-674-0801
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILHM19620305P222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist