| Dr Ayezah Mir, MD | |
|
700 W Jefferson St, Shorewood, IL 60404-7608 | |
| (815) 514-2040 | |
| (815) 741-2860 |
| Full Name | Dr Ayezah Mir |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 700 W Jefferson St, Shorewood, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740227388 | NPI | - | NPPES |
| 036112854 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 036-112854 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ayezah Mir, MD Po Box 713260, Chicago, IL 60677-1260 Ph: (630) 469-9200 | Dr Ayezah Mir, MD 700 W Jefferson St, Shorewood, IL 60404-7608 Ph: (815) 514-2040 |
Mr. Bruno John Jercinovic, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 611 W Jefferson St, Shorewood, IL 60404 Phone: 815-729-1144 Fax: 815-729-2587 | |
Dr. Douglas Ray Bierma Jr., M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 700 W Jefferson St, Shorewood, IL 60431 Phone: 815-741-2888 | |
Dr. Thomas John Moore, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 700 W Jefferson St, Shorewood, IL 60431 Phone: 815-741-2888 | |
Dr. Spomenka Jercinovic, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 611 W Jefferson St, Shorewood, IL 60404 Phone: 815-729-1144 Fax: 815-729-2587 |