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General NPI Number Information
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NPI Number | 1710164249
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Entity Type | Organization
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Legal Business Name | MILLER CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 708 CHURCH ST SUITE 228
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City | EVANSTON
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State | IL
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Zip | 60201-3875
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Country | US
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Telephone | 847-570-0970
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Fax | 847-570-0972
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Provider Business Mailing Address
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Address Line | 708 CHURCH ST SUITE 228
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City | EVANSTON
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State | IL
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Zip | 60201-3875
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Country | US
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Telephone | 847-570-0970
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Fax | 847-570-0972
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. CLAIRE SULLIVAN
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Credential |
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Telephone | 847-570-0970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | IL
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