Individual
DR. DIVAKAR MITHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
225 E CHICAGO AVE DEPT OF, CHICAGO, IL 60611-2991
(312) 227-3550
(312) 227-9450
Mailing address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(312) 227-3550
(312) 227-9450
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
036.147516
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2014
Last updated
09/05/2019
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