Provider Demographics
NPI:1306920293
Name:MICHON, JOHN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:MICHON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1786 MOON LAKE BLVD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-5029
Mailing Address - Country:US
Mailing Address - Phone:847-882-8034
Mailing Address - Fax:847-882-8045
Practice Address - Street 1:1786 MOON LAKE BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-5029
Practice Address - Country:US
Practice Address - Phone:847-882-8034
Practice Address - Fax:847-882-8045
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2009-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2001-01373207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2296397Medicare ID - Type Unspecified
NC89130J0Medicare ID - Type Unspecified
F41082Medicare ID - Type Unspecified