Individual
KATHY JOYCE MIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
8145 N MILWAUKEE AVE, NILES, IL 60714-2828
(847) 470-0555
(847) 470-0019
Mailing address
6442 S CASS AVE, WESTMONT, IL 60559-3209
(630) 493-0600
(630) 493-0686
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
016-005257
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016-005257
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016005257
—
IL
01
—
01632760
BLUE CROSS BLUE SHIELD
IL
01
—
P00467322
RAILROAD MEDICARE
IL
Enumeration date
05/15/2006
Last updated
05/19/2008
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