Individual
ADAM MIETUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6701 W 95TH ST, OAK LAWN, IL 60453-2105
(708) 599-5000
Mailing address
6701 W 95TH ST, OAK LAWN, IL 60453-2105
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
IL
Other
Enumeration date
03/10/2016
Last updated
10/11/2021
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