Healthcare Provider Details

I. General information

NPI: 1407880701
Provider Name (Legal Business Name): STEVEN W. MILLER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W OGDEN AVE
HINSDALE IL
60521-3186
US

IV. Provider business mailing address

550 W OGDEN AVE
HINSDALE IL
60521-3186
US

V. Phone/Fax

Practice location:
  • Phone: 630-323-6116
  • Fax: 630-323-6169
Mailing address:
  • Phone: 630-323-6116
  • Fax: 630-323-6169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number016004872
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: