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NPI Code Detail

MEDICARE: MOLLY JO MULLIGAN M.D.

MEDICARE: MOLLY JO MULLIGAN M.D.
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
12084P0800XPsychiatry Physician036.123570IL

General Provider Information

NPI Number : 1669620951
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY JO MULLIGAN M.D.
Provider Business Mailing Address
First Line : 625 N MICHIGAN AVE STE 2550
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3182
Country : US
Telephone Number : 312-926-8200
Fax Number :
Provider Business Practice Location Address
First Line : 625 N MICHIGAN AVE STE 2550
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3182
Country : US
Telephone Number : 312-926-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2008
Last Update Date : 10/02/2025

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Directions to “ MOLLY JO MULLIGAN M.D.” Practice Location

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