MEDICARE: STEPHEN C MIFF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1912395179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN C MIFF

Provider Business Mailing Address
First Line	:	2740 W FOSTER AVE STE 311
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3547
Country	:	US
Telephone Number	:	773-907-7017
Fax Number	:	773-907-7016

Provider Business Practice Location Address
First Line	:	2740 W FOSTER AVE STE 311
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3547
Country	:	US
Telephone Number	:	773-907-7017
Fax Number	:	773-907-7016

Authorized Official
Title or Position	:	MD
Name	:	STEPHEN C MIFF
Credential	:	MD
Telephone Number	:	773-907-7017

Provider Enumeration Date	:	12/22/2014
Last Update Date	:	12/08/2016

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Directions to “STEPHEN C MIFF ” Practice Location

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