Individual
MIA WERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
675 N SAINT CLAIR ST, SUITE 18-200, CHICAGO, IL 60611-5975
(312) 695-8630
Mailing address
675 N SAINT CLAIR ST, SUITE 18-200, CHICAGO, IL 60611-5975
(312) 695-8630
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004422
IL
Other
Enumeration date
03/25/2013
Last updated
06/09/2015
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