Individual
C. MICHAEL MULLEN IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4440 W 95TH ST STE 2177H, OAK LAWN, IL 60453-2600
(708) 684-5341
(708) 684-4716
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-142684
IL
208000000X
Pediatrics Physician
125.064780
IL
Other
Enumeration date
04/10/2014
Last updated
12/10/2022
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