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General NPI Number Information
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NPI Number | 1497313183
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Entity Type | Individual
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Provider Name | DR. SANDRA MISKIEWICZ
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Gender | Female
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Dates
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Enumeration Date | 05/29/2019
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 1653 W CONGRESS PKWY
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City | CHICAGO
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State | IL
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Zip | 60612-3833
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Country | US
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Telephone | 312-942-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1620 W HARRISON ST
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City | CHICAGO
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State | IL
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Zip | 60612-3801
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Country | US
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Telephone | 312-942-5000
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036165525
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 125.074110
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License Number State | IL
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