Provider Demographics
NPI:1902196215
Name:WARD, ARIKA REBECCA CLARK (MA, CI/CT)
Entity Type:Individual
Prefix:
First Name:ARIKA
Middle Name:REBECCA CLARK
Last Name:WARD
Suffix:
Gender:F
Credentials:MA, CI/CT
Other - Prefix:
Other - First Name:ARIKA
Other - Middle Name:REBECCA
Other - Last Name:CLARK-WARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CI/CT
Mailing Address - Street 1:1658 N MILWAUKEE AVE # 302
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-6905
Mailing Address - Country:US
Mailing Address - Phone:314-412-6121
Mailing Address - Fax:
Practice Address - Street 1:1658 N MILWAUKEE AVE # 302
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-6905
Practice Address - Country:US
Practice Address - Phone:314-412-6121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2010-00064171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter