Individual provider · Type 1 NPI

Violetta Mickiewicz, PA-C

Surgical Physician Assistant · Chicago, IL

NPI number 1053427831 Active

Practice location

4501 N Winchester Ave, 3rd Floor
Chicago, IL 60640-5265

Fax (773) 250-0497

Mailing address

4501 Winchester, 3rd Floor
Chicago, IL 60640

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XNone listed

Surgical Physician Assistant: Definition to come...

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About NPI 1053427831

Violetta Mickiewicz, PA-C's National Provider Identifier is 1053427831, issued on Aug 22, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Chicago, IL. The record was last updated on Oct 4, 2007.