MEDICARE: DR. KIMBERLY M BATTLE-MILLER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	036089483	IL
2	2080H0002X	Pediatric Hospice and Palliative Medicine Physician	036089483	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	F400192396	OTHER	IL	MEDICARE PTAN (INDIVIDUAL)
5	206147	OTHER	IL	MEDICARE PTAN (GROUP)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01635624	OTHER	IL	BCBS PROVIDER NUMBER
3	036089483	OTHER	IL	LICENSE #
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588658447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY M BATTLE-MILLER M.D.

Provider Business Mailing Address
First Line	:	29373 NETWORK PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-1293
Country	:	US
Telephone Number	:	847-390-5900
Fax Number	:

Provider Business Practice Location Address
First Line	:	3825 HIGHLAND AVE STE 5B
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1551
Country	:	US
Telephone Number	:	630-963-9963
Fax Number	:	630-963-9667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	05/19/2022

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Directions to “ DR. KIMBERLY M BATTLE-MILLER M.D.” Practice Location

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