Organization
ACTION PHYSICAL MEDICINE & REHABILITATION, SC
Active
Organization
ACTION PHYSICAL MEDICINE & REHABILITATION, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MIKUZIS D.O. (OWNER)
(815) 725-4918
Entity
Organization
Contact information
Practice address
850 BROOK FOREST AVE, UNIT F, SHOREWOOD, IL 60404-8513
(815) 725-4918
(815) 725-4955
Mailing address
850 BROOK FOREST AVE, UNIT F, SHOREWOOD, IL 60404-8513
(815) 725-4918
(815) 725-4955
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4521533
BC/BS OF IL
IL
Enumeration date
01/24/2006
Last updated
04/20/2008
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