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General NPI Number Information
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NPI Number | 1467598235
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Entity Type | Individual
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Provider Name | MARIUSZ MILEJCZYK MD
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Gender | Male
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 1880 W WINCHESTER RD STE 106
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-5321
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Country | US
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Telephone | 847-367-4277
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Fax | 847-810-0287
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Provider Business Mailing Address
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Address Line | 15 TOWER CRT 255
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City | GURNEE
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State | IL
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Zip | 60031
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Country | US
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Telephone | 847-623-8818
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Fax | 847-625-8059
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036093940
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License Number State | IL
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