Individual
CECYLIA K. MIZERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5140 N CALIFORNIA AVE STE 560, CHICAGO, IL 60625-2577
(773) 275-4496
(773) 784-6141
Mailing address
5140 N. CALIFORNIA AVE., SUITE 560-GMP, CHICAGO, IL 60625
(773) 293-8878
(773) 293-8879
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036110827
IL
2086X0206X
Surgical Oncology Physician
Primary
036110827
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036110827
—
IL
Enumeration date
08/08/2006
Last updated
11/16/2023
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