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General NPI Number Information
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NPI Number | 1487103453
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Entity Type | Organization
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Legal Business Name | WILLIAM E.P. MCMILLER, MD & ASSOCIATES LLC
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Dates
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Enumeration Date | 09/30/2016
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Last Update Date | 09/30/2016
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Provider Practice Location Address
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Address Line | 18 LAKE ST
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City | OAK PARK
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State | IL
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Zip | 60302-2606
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Country | US
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Telephone | 708-434-0336
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Fax | 708-575-0180
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Provider Business Mailing Address
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Address Line | PO BOX 706
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City | OAK PARK
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State | IL
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Zip | 60303-0706
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Country | US
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Telephone | 708-434-0336
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Fax | 708-575-0180
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM PEDRO MCMILLER
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Credential | M.D. M.P.H.
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Telephone | 708-434-0336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 036-078553
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License Number State | IL
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