Doctor Name: | BRETT ALLEN MILKEVITCH |
NPI Number: | 1053768051 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP |
License Number: | 209014299 |
Business Practice Address: | 211 Dixie Hwy Chicago Heights, IL - 604111696 |
Business Phone Number: | 7087557069 |
Business Fax Number: | |
Mailing Address: | 9241 S 83rd Ct, HICKORY HILLS |
State: | IL |
Postal Code: | 604571929 |
Phone Number: | 7084917837 |
Fax Number: | |
NPI Enumeration Date: | 05/19/2016 |
NPI Last Update Date: | 05/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 209014299 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |