Provider Demographics
NPI:1255381877
Name:MIKES, PATRICIA SUSAN (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:SUSAN
Last Name:MIKES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5507 S OAK ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-5063
Mailing Address - Country:US
Mailing Address - Phone:312-320-5370
Mailing Address - Fax:630-734-1827
Practice Address - Street 1:911 N ELM ST STE 328
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3642
Practice Address - Country:US
Practice Address - Phone:630-222-2951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036063514207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK29004Medicare ID - Type Unspecified
IL201621Medicare ID - Type Unspecified
ILE87354Medicare UPIN