Individual
VIOLETTA MICKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4501 N WINCHESTER AVE, 3RD FLOOR, CHICAGO, IL 60640-5265
(773) 250-0500
(773) 250-0497
Mailing address
4501 WINCHESTER, 3RD FLOOR, CHICAGO, IL 60640
(773) 250-0500
(773) 250-0497
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
IL
Other
Enumeration date
08/22/2006
Last updated
10/04/2007
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