Individual
MIKAELA SHAPIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
24600 W 127TH ST STE 335, PLAINFIELD, IL 60585-9558
(815) 676-6716
Mailing address
15 PARKWAY NORTH BLVD APT 248, DEERFIELD, IL 60015-2573
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085010210
IL
Other
Enumeration date
08/19/2024
Last updated
10/10/2024
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