Provider Demographics
NPI:1710143581
Name:GEERS, MILLICENT ODUNZE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MILLICENT
Middle Name:ODUNZE
Last Name:GEERS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-8179
Mailing Address - Country:US
Mailing Address - Phone:719-633-5255
Mailing Address - Fax:312-695-5672
Practice Address - Street 1:77 3RD ST
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-8179
Practice Address - Country:US
Practice Address - Phone:719-633-5255
Practice Address - Fax:312-695-5672
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36114563208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36114563OtherILLINOIS PHYSICIAN LICENSE