Individual
MIKAYLA FREESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
125.074801
IL
208600000X
Surgery Physician
Primary
36560
NE
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/29/2019
Last updated
03/03/2026
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