Individual
JEREMIAH MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4450 OAKWOOD LN, MATTESON, IL 60443-1825
(708) 828-2438
Mailing address
612 GOLDENROD CIR, MATTESON, IL 60443-1769
(708) 828-2438
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
1385400
IL
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
1385401
IL
Other
Enumeration date
12/29/2021
Last updated
12/29/2021
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