Healthcare Provider Details

I. General information

NPI: 1437100856
Provider Name (Legal Business Name): MICHAEL MILORO DMD, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S PAULINA ST
CHICAGO IL
60612-7210
US

IV. Provider business mailing address

801 S PAULINA ST
CHICAGO IL
60612-7210
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-1052
  • Fax: 312-996-1052
Mailing address:
  • Phone: 312-996-1052
  • Fax: 312-996-5987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number021002254
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number021002254
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number036.119907
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number137000717
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019027559
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: