Individual
JACQUELINE MITZNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
1925 N CLYBOURN AVE STE 300, CHICAGO, IL 60614-7395
(773) 697-8839
Mailing address
1565 W BIRCHWOOD AVE APT 2, CHICAGO, IL 60626-1748
(802) 304-3007
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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