Individual
MEGAN MIETELSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10 MARTIN AVE STE 100, NAPERVILLE, IL 60540-6564
(630) 369-7700
(630) 369-7705
Mailing address
10 MARTIN AVE STE 100, NAPERVILLE, IL 60540-6564
(630) 369-7700
(630) 369-7705
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01073767A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036142172
—
IL
01
—
F400368541
MEDICARE PTAN
IL
Enumeration date
03/31/2010
Last updated
02/04/2021
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