Individual
JOHN D. MIKUZIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
850 BROOK FOREST AVE, UNIT F, SHOREWOOD, IL 60404-8513
(815) 725-4918
(815) 725-4955
Mailing address
850 BROOK FOREST AVE, UNIT F, SHOREWOOD, IL 60404-8513
(815) 725-4918
(815) 725-4955
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036077741
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036077741
—
IL
01
—
158372300
DEPT OF LABOR
IL
01
—
4521533
BC/BS
IL
Enumeration date
01/26/2006
Last updated
12/14/2009
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