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Jill Idicula
NPI 1093290553 · on the registry since 2018
Practice
- Address
- University Pediatricians Autism Center
16700 17 Mile Road Suite B
Clinton Township, MI 48038 - Phone
- (586) 228-2300
- Fax
- (586) 228-2307
Additional practice sites
- 1800 W Big Beaver Rd Ste 150, Troy, MI
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Also registered as
- 106S00000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-04-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan