SearchIllinois374U00000X

Octavia Mitchell

NPI 1649922238 · on the registry since 2022 · sole proprietor

Practice

Address
5107 S Blackstone Ave Apt 1104
Chicago, IL 60615
Phone
(312) 581-1770

Registry record

Primary taxonomy
374U00000X
374U00000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2022-01-25

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois