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NPI Code Detail

MEDICARE: DR. JOAN C MULLAN MD

MEDICARE: DR. JOAN C MULLAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician036087186IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396856019
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOAN C MULLAN MD
Provider Business Mailing Address
First Line : 211 E CHICAGO AVE
Second Line : SUITE 1050
City : CHICAGO
State : IL
Zip : 60611-2637
Country : US
Telephone Number : 312-944-6677
Fax Number : 312-944-3346
Provider Business Practice Location Address
First Line : 211 E CHICAGO AVE
Second Line : SUITE 1050
City : CHICAGO
State : IL
Zip : 60611-2637
Country : US
Telephone Number : 312-944-6677
Fax Number : 312-944-3346
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JOAN C MULLAN MD” Practice Location

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