Individual
ERIC MIZUNO
Active
Individual
ERIC MIZUNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-082731
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-082731
—
IL
01
—
10640555
CAQH
IL
01
—
F400186347
MEDICARE
IL
01
—
QXIPQ0000100695
AETNA BETTER HEALTH
IL
Enumeration date
06/27/2006
Last updated
03/07/2023
Update your record
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