Provider Demographics
NPI:1881478345
Name:SIK MED LLC
Entity type:Organization
Organization Name:SIK MED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIKOREVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-564-6379
Mailing Address - Street 1:10120 HOMESTEAD CT
Mailing Address - Street 2:
Mailing Address - City:CEDAR LAKE
Mailing Address - State:IN
Mailing Address - Zip Code:46303-7191
Mailing Address - Country:US
Mailing Address - Phone:347-564-6379
Mailing Address - Fax:
Practice Address - Street 1:10120 HOMESTEAD CT
Practice Address - Street 2:
Practice Address - City:CEDAR LAKE
Practice Address - State:IN
Practice Address - Zip Code:46303-7191
Practice Address - Country:US
Practice Address - Phone:347-564-6379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care