Individual
MIKALA PACIFIQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
627 S WOOD ST, CHICAGO, IL 60612
(312) 864-0394
Mailing address
627 S WOOD ST, CHICAGO, IL 60612-3821
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
125065632
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/16/2014
Last updated
02/11/2022
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