Individual
BORIS MIOKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3333 N SEMINARY ST, GALESBURG, IL 61401-1251
(309) 343-5114
Mailing address
40 PROSPECT ST., BUILDING 2 APT 2K, NORWALK, CT 06850
(347) 656-4595
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036169455
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2021
Last updated
05/24/2024
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