Individual
DR. MARILYN L. MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2075 FOXFIELD RD, SUITE 102, ST CHARLES, IL 60174-1402
(847) 304-5526
Mailing address
2075 FOXFIELD RD, SUITE 102, ST CHARLES, IL 60174-1402
(847) 304-5526
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
036-063042
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
748450
MEDICARE PROVIDER NUMBER
IL
Enumeration date
10/19/2005
Last updated
12/03/2014
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