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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