Healthcare Provider Details

I. General information

NPI: 1447239173
Provider Name (Legal Business Name): MARGARET SIDLES MILLAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 JOHN DEERE RD STE 401
MOLINE IL
61265
US

IV. Provider business mailing address

600 JOHN DEERE RD STE 401
MOLINE IL
61265-6869
US

V. Phone/Fax

Practice location:
  • Phone: 309-779-4950
  • Fax: 309-779-4905
Mailing address:
  • Phone: 309-779-4950
  • Fax: 309-779-4905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036-078142
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036.078142
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: