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General NPI Number Information
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NPI Number | 1902905078
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Entity Type | Individual
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Provider Name | GEORGE ANDREW MIKELL DC
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Gender | Male
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6418 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60634
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Country | US
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Telephone | 773-230-1358
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Fax |
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Provider Business Mailing Address
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Address Line | 12170 SUMMER RIDGE LANE
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City | HUNTLEY
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State | IL
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Zip | 60142-7731
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Country | US
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Telephone | 847-669-8982
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 382864
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License Number State | IL
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