Organization
DOCTOR CHARLES D MULLENIX MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES DENNIS MULLENIX (OWNER PRESIDENT)
(847) 724-6617
Entity
Organization
Contact information
Practice address
1775 GLENVIEW RD, SUITE 114, GLENVIEW, IL 60025-2975
(847) 724-6617
(847) 724-3123
Mailing address
1775 GLENVIEW RD, SUITE 114, GLENVIEW, IL 60025-2975
(847) 724-6617
(847) 724-3123
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01605282
BLUE CROSS
—
01
—
0538000001
DMERC
—
01
—
4028871
AETNA
—
Enumeration date
08/15/2007
Last updated
03/07/2023
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