MEDICARE: DR. AVANI ASHOK PATEL-MILLER DC, ND

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	111N00000X	Chiropractor	038011605	IL

General Provider Information

NPI Number	:	1710219258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AVANI ASHOK PATEL-MILLER DC, ND

Provider Business Mailing Address
First Line	:	125 S WACKER DR
Second Line	:	SUITE #300
City	:	CHICAGO
State	:	IL
Zip	:	60606-4424
Country	:	US
Telephone Number	:	312-258-1338
Fax Number	:	312-893-5895

Provider Business Practice Location Address
First Line	:	400 N MCCLURG CT APT 2206
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-4377
Country	:	US
Telephone Number	:	650-678-5669
Fax Number	:

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

Provider Enumeration Date	:	02/09/2010
Last Update Date	:	07/28/2020

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