Provider Demographics
NPI:1063508190
Name:OLIVIER, MILDRED MG (MD)
Entity Type:Individual
Prefix:
First Name:MILDRED
Middle Name:MG
Last Name:OLIVIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1555 N. BARRINGTON RD
Mailing Address - Street 2:STE 110
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1019
Mailing Address - Country:US
Mailing Address - Phone:847-882-5848
Mailing Address - Fax:847-882-3060
Practice Address - Street 1:1555 BARRINGTON RD
Practice Address - Street 2:STE 110
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1019
Practice Address - Country:US
Practice Address - Phone:847-882-5848
Practice Address - Fax:847-882-3060
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036086386207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036086386Medicaid
IL036086386Medicaid