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Organization

TANIA MIKAITIS APN SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS TANIA M MIKAITIS APNCNP (PRESIDENT)
(312) 404-0244
Entity
Organization

Contact information

Practice address
956 BURGESS CIR, BUFFALO GROVE, IL 60089-1205
(312) 404-0244
(312) 276-4299
Mailing address
956 BURGESS CIR, BUFFALO GROVE, IL 60089-1205
(312) 404-0244
(312) 276-4299

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209005514
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1104873140
TYPE I NPI
IL
01
209005514
LICENSED APNCNP
IL
Enumeration date
05/15/2007
Last updated
03/29/2010
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