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Contact Information

JEREMIAH MITCHELL
4450 OAKWOOD LN
MATTESON, IL60443-1825
 Phone: 708-828-2438
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for JEREMIAH MITCHELL · (Male)

NPI # 1447910682
Status Active
Credentials
Entity Individual
Enumeration date 12/29/2021
Last updated 12/29/2021 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 1385400
  • IL License # 1385401
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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