Provider Demographics
NPI:1588748032
Name:SHIKORA, HEIDI (PSYD)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:
Last Name:SHIKORA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:
Other - Last Name:FINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:317 RONNIE DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1149
Mailing Address - Country:US
Mailing Address - Phone:847-744-2591
Mailing Address - Fax:847-955-1496
Practice Address - Street 1:135 N ARLINGTON HEIGHTS RD STE 105
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-8215
Practice Address - Country:US
Practice Address - Phone:847-744-2591
Practice Address - Fax:847-777-0586
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005838103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212006Medicare ID - Type UnspecifiedUNIQUE PROVIDER NUMBER