Individual
TANIA MIKAITIS-ROSSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
6201 W TOUHY AVE, CHICAGO, IL 60646-1100
(224) 508-0382
(888) 255-4358
Mailing address
6201 W TOUHY AVE, CHICAGO, IL 60646-1100
(224) 508-0382
(888) 255-4358
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209005514
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295941573
TYPE 2 NPI
IL
Enumeration date
05/27/2006
Last updated
02/02/2016
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