Individual
MARK D MINIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 S CALIFORNIA AVE STE 100, CHICAGO, IL 60608
(773) 584-6200
Mailing address
2001 S CALIFORNIA AVE STE 100, CHICAGO, IL 60608-2486
(773) 640-5785
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036137053
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036137053
—
IL
Enumeration date
11/01/2006
Last updated
09/29/2020
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