Most Relevant Information
Provider Data
| NPI Number: | 1003446212 |
| Provider Name: | ANDREA JEAN WAKIM NIKOLIS MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/16/2020 |
| Last Updated: | 04/27/2023 |
Provider Practice Location
12631 E 17TH AVE
AURORA
CO
800452527
Practice Location Phone/Fax
| Phone: | 3037247408 |
| Fax: |
Provider Mailing Location
107 OAK RIDGE DR W
BURR RIDGE
IL
605276868
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |