Healthcare Provider Details

I. General information

NPI: 1922290600
Provider Name (Legal Business Name): EMILY S MILLER MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 PLAIN ST FL 6
PROVIDENCE RI
02903-4829
US

IV. Provider business mailing address

675 N SAINT CLAIR ST STE 14-200
CHICAGO IL
60611-5966
US

V. Phone/Fax

Practice location:
  • Phone: 401-274-1122
  • Fax: 401-453-7622
Mailing address:
  • Phone: 312-695-7542
  • Fax: 312-695-5462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD18502
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number126052434
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number291936
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number036127607
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number291936
License Number StateMA
# 6
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMD18502
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: