Individual
MARK E MITTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2456 SHERIDAN ROAD, ZION, IL 60099
(847) 872-5707
(847) 746-5892
Mailing address
2456 SHERIDAN ROAD, ZION, IL 60099
(847) 872-5707
(847) 746-5892
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038007312
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04906739
BCBS
IL
Enumeration date
11/29/2006
Last updated
07/08/2007
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