Organization
MIKELSON & MIKELSON P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT C. MIKELSON JR. D.D.S. (PRESIDENT)
(773) 233-6300
Entity
Organization
Contact information
Practice address
3838 W 111TH ST STE 105, CHICAGO, IL 60655-4042
(773) 233-6300
Mailing address
3838 W 111TH ST STE 105, CHICAGO, IL 60655-4042
(773) 233-6300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
10/02/2007
Last updated
10/02/2007
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