Individual
MICHEL MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5841 S MARYLAND AVE, MC 3077, CHICAGO, IL 60637-1443
(773) 702-0529
Mailing address
5841 S MARYLAND AVE, MC 3077, CHICAGO, IL 60637-1443
(773) 702-0529
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
125067445
IL
Other
Enumeration date
06/22/2015
Last updated
12/22/2021
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