Mysiak, Waldemar

Mysiak, Waldemar is an sole proprietor health care provider with primary practice located at 755 S Milwaukee Ave Suite 261, Libertyville IL 60048-3253. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mysiak, Waldemar can be contacted via phone (847) 281-1100.

Contact Information

Primary practice address
755 S Milwaukee Ave Suite 261 Libertyville IL 60048-3253
Phone: (847) 281-1100
Fax: (847) 281-1300
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036099938 Illinois

Profile Details

NPI number 1972567717
LBN Legal business name Mysiak, Waldemar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 17th, 2006
Last updated Feb 14th, 2017 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1972567717 NPPES
Illinois MEDICAID 036099938
Illinois Other 04932174
Illinois Other 364406567

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