| Mary J Mikhailov, MD | |
|
25 N Winfield Rd, Winfield, IL 60190-1295 | |
| (630) 260-0600 | |
| (630) 260-1370 |
| Full Name | Mary J Mikhailov |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 25 N Winfield Rd, Winfield, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700817244 | NPI | - | NPPES |
| 363149833 | Other | IL | TAX IDENTIFICATION NUMBER |
| 0222075 | Other | IL | BLUE CROSS GROUP NUMBER |
| 548190001 | Other | IL | MEDICARE INDIVIDUAL PTAN |
| 3631498336019001 | Other | IL | CDPG HFS PAYEE ID |
| 036078879 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 036078879 (Illinois) | Primary |
| Entity Name | Central Dupage Physician Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033149844 PECOS PAC ID: 5890696231 Enrollment ID: O20040303000601 |
| Mailing Address | Practice Location Address |
|---|---|
| Mary J Mikhailov, MD 25 N Winfield Rd, Winfield, IL 60190-1295 Ph: (630) 260-0600 | Mary J Mikhailov, MD 25 N Winfield Rd, Winfield, IL 60190-1295 Ph: (630) 260-0600 |
Dr. Melissa J Manrique, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 25 N Winfield Rd, Winfield, IL 60190 Phone: 773-880-4000 | |
Laura S Ling, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 25 Winfield Road, Central Du Page Hospital, Winfield, IL 60190 Phone: 630-933-1600 | |
Justin Dey, Pediatrics Medicare: Medicare Enrolled Practice Location: 25 N Winfield Rd, Winfield, IL 60190 Phone: 630-933-1600 Fax: 312-227-6090 | |
Dr. Nimra E Alvi, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 25 N Winfield Rd Ste 204, Winfield, IL 60190 Phone: 630-232-0202 Fax: 630-690-2293 | |
Mary Mccauley, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 25 N Winfield Rd, Winfield, IL 60190 Phone: 312-227-6090 | |
Dr. Mujahida Baram, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 25 N Winfield Rd, Winfield, IL 60190 Phone: 630-933-1600 | |
Dr. Aroop Kumar Kar, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 25 N Winfield Rd, Pediatric Outpatient East Clinic, Winfield, IL 60190 Phone: 630-933-4291 Fax: 630-933-4225 |