Miyake, Madison Jean Keiko

Miyake, Madison Jean Keiko is an individual health care provider with primary practice located at 610 S Maple Ave Ste 1500 , Oak Park IL 60304-2800. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Miyake, Madison Jean Keiko can be contacted via phone (312) 563-3970.

Contact Information

Primary practice address
610 S Maple Ave Ste 1500 Oak Park IL 60304-2800
Phone: (312) 563-3970
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085.009949 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 085.009949 Illinois

Profile Details

NPI number 1932981966
LBN Legal business name Miyake, Madison Jean Keiko
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2023
Last updated Oct 16th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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