(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003551979
Provider Name: MILICA IVANOV NP
Entity Type: Individual
Taxonomy Code: 363LF0000X
Specialty: Nurse Practitioner
License Number: 71012485A
Most Important Dates
Enumeration Date: 05/04/2022
Last Updated: 05/04/2022
Provider Practice Location
1532 CALUMET AVE
DYER
IN
463111588
Practice Location Phone/Fax
Phone: 2195154700
Fax:
Provider Mailing Location
10110 DONALD S POWERS DR
SUITE 101D
MUNSTER
IN
46321
Provider Mailing Phone/Fax
Phone: 2193017264
Fax: