Individual
MICHELLE PHILIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 GLENWOOD AVE, JOLIET, IL 60435-5487
(815) 999-3400
(815) 730-6382
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036148194
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036148194
—
IL
Enumeration date
04/09/2015
Last updated
08/17/2023
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