Individual
MIDHUN AJIKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
333 MADISON ST, JOLIET, IL 60435-8200
(815) 725-7133
Mailing address
311 S WACKER DR STE 1460, CHICAGO, IL 60606-6623
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085010542
IL
363A00000X
Physician Assistant
—
—
Other
Enumeration date
06/12/2024
Last updated
10/02/2024
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