Individual
PHYLLIS MICHELLE MUELLNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 SILVER CROSS BLVD, NEW LENOX, IL 60451-9509
(815) 300-7904
Mailing address
355 E ERIE ST, CHICAGO, IL 60611-3167
(312) 238-1000
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036-099032
IL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
036-099032
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036099032
—
IL
01
—
250011649
RAILROAD MEDICARE
IL
01
—
250011937
RAILROAD MEDICARE
IL
Enumeration date
08/01/2006
Last updated
07/21/2022
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