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Individual

MRS. MICHELLE RENEE AXIUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN-BC

Contact information

Practice address
9354 S ALBANY AVE, EVERGREEN PARK, IL 60805-2420
(708) 769-4758
Mailing address
2000 GREEN RD, ANN ARBOR, MI 48105-1598
(734) 686-6361

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-007967
IL
363LF0000X
Family Nurse Practitioner
209.007967
IL

Other

Enumeration date
02/02/2010
Last updated
03/01/2018
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