Individual
MARY KATE MINEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
18425 WEST CREEK DR, STEF, TINLEY PARK, IL 60477-2220
(708) 209-6783
Mailing address
18425 WEST CREEK DR, STEF, TINLEY PARK, IL 60477-2220
(708) 209-6783
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006767
IL
Other
Enumeration date
10/17/2018
Last updated
12/14/2021
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