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1730254434
MITCHELL S BLIVAISS
EVANSTON, IL
NPI
1730254434
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: IL 036055083)
Enumeration Date
2006-11-21
Last Update Date
2007-07-08
Business Address
-- MITCHELL S BLIVAISS MD
909 DAVIS ST SUITE 200
EVANSTON, IL 60201-3645
Phone number: 847-866-3700
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Mailing Address
-- MITCHELL S BLIVAISS MD
2650 RIDGE AVE EVANSTON HOSPITAL
EVANSTON, IL 60201-1718
Phone number: 847-570-1206
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