Healthcare Provider Details

I. General information

NPI: 1003978735
Provider Name (Legal Business Name): PATRICIA A MUELLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2006
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 E WACKER PL 805
CHICAGO IL
60601-7296
US

IV. Provider business mailing address

111 N WABASH AVE STE 1911
CHICAGO IL
60602-2967
US

V. Phone/Fax

Practice location:
  • Phone: 312-368-9499
  • Fax:
Mailing address:
  • Phone: 312-368-9499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number3641427
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: