Mikhailov, Mary J

Mikhailov, Mary J is an individual health care provider with primary practice located at 25 N Winfield Rd , Winfield IL 60190-1295. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mikhailov, Mary J can be contacted via phone (630) 260-0600.

Contact Information

Primary practice address
25 N Winfield Rd Winfield IL 60190-1295
Phone: (630) 260-0600
Fax: (630) 260-1370
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036078879 Illinois

Profile Details

NPI number 1700817244
LBN Legal business name Mikhailov, Mary J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Nov 3rd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700817244 NPPES
Illinois Other 363149833 TAX IDENTIFICATION NUMBER
Illinois Other 0222075 TAX IDENTIFICATION NUMBER
Illinois Other 548190001 TAX IDENTIFICATION NUMBER
Illinois Other 3631498336019001 TAX IDENTIFICATION NUMBER
Illinois MEDICAID 036078879 TAX IDENTIFICATION NUMBER

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