Provider Demographics
NPI:1720594013
Name:MILEVA, VIKTORIA (RN BSN)
Entity Type:Individual
Prefix:
First Name:VIKTORIA
Middle Name:
Last Name:MILEVA
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 TALLMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-1746
Mailing Address - Country:US
Mailing Address - Phone:815-701-1559
Mailing Address - Fax:
Practice Address - Street 1:236 TALLMAN AVE
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-1746
Practice Address - Country:US
Practice Address - Phone:815-701-1559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041445455163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Single Specialty