Healthcare Provider Details

I. General information

NPI: 1700307709
Provider Name (Legal Business Name): STEPHANIE MILLER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2017
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 OGDEN AVE STE 225
AURORA IL
60504
US

IV. Provider business mailing address

2000 OGDEN AVE STE P050
AURORA IL
60504-5893
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-4800
  • Fax: 630-978-6791
Mailing address:
  • Phone: 304-992-4046
  • Fax: 304-994-7506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number209016230
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: