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General NPI Number Information
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NPI Number | 1801314794
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Entity Type | Individual
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Provider Name | KATIE HOANG MIAO OD
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Gender | Female
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Dates
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Enumeration Date | 08/31/2017
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 2700 N NARRAGANSETT AVE
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City | CHICAGO
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State | IL
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Zip | 60639-1083
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Country | US
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Telephone | 773-622-2405
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Fax |
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Provider Business Mailing Address
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Address Line | 474 N LAKE SHORE DR APT 4005
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City | CHICAGO
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State | IL
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Zip | 60611-6483
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Country | US
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Telephone | 312-833-1605
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 12715650-9934
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT003405
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 113143
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046.011148
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1986932AT
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License Number State | LA
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