Individual
MICHIKO OTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
250 E SUPERIOR ST FL 16, CHICAGO, IL 60611-2914
(312) 472-3665
(312) 472-4223
Mailing address
250 E SUPERIOR ST FL 16, CHICAGO, IL 60611-2914
(312) 472-3665
(312) 472-4223
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/22/2024
Last updated
01/23/2025
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