Mysiak, Waldemar
Mysiak, Waldemar is an sole proprietor health care provider with primary practice located at 755 S Milwaukee Ave Suite 261, Libertyville IL 60048-3253. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mysiak, Waldemar can be contacted via phone (847) 281-1100.Contact Information
Primary practice address
755 S Milwaukee Ave Suite 261
Libertyville IL 60048-3253
Phone: (847) 281-1100
Fax: (847) 281-1300
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036099938 | Illinois |
Profile Details
| NPI number | 1972567717 |
|---|---|
| LBN Legal business name | Mysiak, Waldemar |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 17th, 2006 |
| Last updated | Feb 14th, 2017 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972567717 | NPPES |
| Illinois | MEDICAID | 036099938 | |
| Illinois | Other | 04932174 | |
| Illinois | Other | 364406567 |
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