Healthcare Provider Details

I. General information

NPI: 1407922628
Provider Name (Legal Business Name): GLORIA MILLARE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GLORIA G FLORES MD

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 11/10/2020
Certification Date: 11/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W HIGGINS ROAD SUITE 340
HOFFMAN ESTATES IL
60169
US

IV. Provider business mailing address

2500 W HIGGINS ROAD SUITE 340
HOFFMAN ESTATES IL
60169
US

V. Phone/Fax

Practice location:
  • Phone: 847-524-1002
  • Fax: 847-524-1181
Mailing address:
  • Phone: 847-524-1002
  • Fax: 847-524-1181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number036046131
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: