Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 036-103892 | IL |
NPI | 1003943614 |
---|---|
Provider Name | Mihaela Mihailescu |
First Address | Chicago, IL 60605-2803 |
Second Address | Oak Lawn, IL 60453-2600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 30/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H60139 | (02) | IL |
L91466 | PROVIDER NUMBER (01) | IL |