Individual
DAVID GEORGE MIDLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.C.T,BA
Contact information
Practice address
6686 DOUBLE EAGLE DR, UNIT 103, WOODRIDGE, IL 60517-5428
(630) 663-9811
(630) 663-9018
Mailing address
6686 DOUBLE EAGLE DR, UNIT 103, WOODRIDGE, IL 60517-5428
(630) 663-9811
(630) 663-9018
Taxonomy
Speciality
Code
Description
License number
State
2471C1101X
Cardiovascular-Interventional Technology Radiologic Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
364429849001
—
IL
01
—
BLUE CROSS
02230032
IL
Enumeration date
03/29/2007
Last updated
07/08/2007
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