Healthcare Provider Details

I. General information

NPI: 1093196552
Provider Name (Legal Business Name): JARED RICHARD MILLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2015
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MID AMERICA PLZ STE 1000
OAKBROOK TERRACE IL
60181-4710
US

IV. Provider business mailing address

1 MID AMERICA PLZ STE 1000
OAKBROOK TERRACE IL
60181-4710
US

V. Phone/Fax

Practice location:
  • Phone: 630-599-7526
  • Fax:
Mailing address:
  • Phone: 630-599-7526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number036.147739
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: