Individual
DR. HEIDI CHRISTINE MEMMEL MITIDIERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 N WESTMORELAND RD, LAKE FOREST, IL 60045-1658
(847) 582-2134
(847) 535-7285
Mailing address
1000 N WESTMORELAND RD, LAKE FOREST, IL 60045-1658
(847) 582-2134
(847) 535-7285
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036107710
IL
208600000X
Surgery Physician
36107710
IL
Other
Enumeration date
05/24/2006
Last updated
08/11/2023
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