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General NPI Number Information
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NPI Number | 1083747257
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Entity Type | Individual
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Provider Name | MICHELE LYNN WINIARZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 01/19/2017
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Provider Practice Location Address
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Address Line | 9669 KENTON AVE SUITE 300
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City | SKOKIE
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State | IL
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Zip | 60076-1266
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Country | US
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Telephone | 847-677-4205
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Fax | 847-677-4209
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Provider Business Mailing Address
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Address Line | 3040 W SALT CREEK LN
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-1069
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Country | US
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Telephone | 847-870-4780
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Fax | 847-483-7447
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 085-001402
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License Number State | IL
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