IndividualActive
Joseph Minich, OTHER
NPI 1346454808 · Independent Duty Corpsman · Great Lakes, IL
Provider details
- NPI number
- 1346454808
- Entity type
- Individual
- Primary specialty
- Independent Duty CorpsmanOther Service Providers
- Credential
- OTHER
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
2410 Sampson St Bldg 237
Great Lakes, IL 60088-2942
Phone: (847) 688-2469
Approximate (ZIP-level) locationGet directions
Mailing address
9517 69th St
Kenosha, WI 53142-8114
Registry dates
- Enumerated
- 2007-05-10
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.