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MRS. MILICA IVANOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1532 CALUMET AVE, DYER, IN 46311-1588
(219) 515-4700
Mailing address
10110 DONALD S POWERS DR, SUITE 101D, MUNSTER, IN 46321
(219) 301-7264

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71012485A
IN

Other

Enumeration date
05/04/2022
Last updated
05/04/2022
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