Healthcare Provider Details

I. General information

NPI: 1285757773
Provider Name (Legal Business Name): THE FERTILITY INSTITUTE AT EDWARD/CHARLES E MILLER MD ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 OSLER DRIVE
NAPERVILLE IL
60540
US

IV. Provider business mailing address

120 OSLER DRIVE
NAPERVILLE IL
60540
US

V. Phone/Fax

Practice location:
  • Phone: 630-428-2229
  • Fax:
Mailing address:
  • Phone: 630-428-2229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLES E MILLER
Title or Position: PHYSICIAN
Credential: MD
Phone: 847-593-1040