Healthcare Provider Details

I. General information

NPI: 1578576724
Provider Name (Legal Business Name): MICHAEL L MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 E CHICAGO AVENUE LURIE CHILDREN'S HOSPITAL #50 DIVISION OF RHEUMATOLOGY
CHICAGO IL
60611
US

IV. Provider business mailing address

255 E CHICAGO AVENUE LURIE CHILDREN'S HOSPITAL #50 DIVISION OF RHEUMATOLOGY
CHICAGO IL
60611
US

V. Phone/Fax

Practice location:
  • Phone: 312-227-6270
  • Fax: 312-227-9417
Mailing address:
  • Phone: 312-227-6270
  • Fax: 312-227-9417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number036054933
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: