Individual
MONIKA AGATA SIEDLARZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14933 FOUNDERS XING, LOCKPORT, IL 60491-6712
(708) 778-3001
Mailing address
16200 GOLFVIEW DR, LOCKPORT, IL 60441-4655
(708) 778-3001
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036.149439
IL
208000000X
Pediatrics Physician
MD169639
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5006822027
—
OR
Enumeration date
07/05/2011
Last updated
09/10/2020
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