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General NPI Number Information
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NPI Number | 1225211600
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Entity Type | Individual
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Provider Name | JOHN JOSEPH MILLICHAP M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/09/2007
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 1 E ERIE ST STE 525-4066
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City | CHICAGO
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State | IL
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Zip | 60611-2740
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Country | US
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Telephone | 833-530-3034
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Fax | 833-464-3529
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Provider Business Mailing Address
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Address Line | 1 E ERIE ST STE 525-4066
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City | CHICAGO
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State | IL
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Zip | 60611-2740
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Country | US
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Telephone | 833-530-3034
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Fax | 833-464-3529
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | 036118282
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | 2024-00978
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | 01086832A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 036118282
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License Number State | IL
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