Organization
GILES B. MIZOCK M.D. LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GILES B. MIZOCK M.D. (PRESIDENT)
(847) 509-0547
Entity
Organization
Contact information
Practice address
5025 W. PAULINA, METHODIST HOSP, CHICAGO, IL 60609
(773) 271-9040
Mailing address
2587 FAIRFORD LANE, NORTHBROOK, IL 60062
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-035966
IL
Other
Enumeration date
03/09/2011
Last updated
03/09/2011
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