Individual
DR. MIA SONIA SCHULTZ TANAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2321
Mailing address
2408 W RESERVOIR BLVD, PEORIA, IL 61615-4224
(925) 519-2088
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
125.058312
IL
Other
Enumeration date
07/08/2010
Last updated
02/11/2022
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