=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750376638
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MILLER EYE CENTER LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2005
-----------------------------------------------------
Last Update Date | 08/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2995 EASTROCK DR
-----------------------------------------------------
City | ROCKFORD
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61109-1737
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-226-1500
-----------------------------------------------------
Fax | 815-484-9600
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2995 EASTROCK DR PO BOX 7267
-----------------------------------------------------
City | ROCKFORD
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61109-1737
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-226-1500
-----------------------------------------------------
Fax | 815-484-9600
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. RICHARD A MILLER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 815-226-1500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number | 03606603
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------