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General NPI Number Information
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NPI Number | 1851860407
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Entity Type | Individual
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Provider Name | BENJAMIN JOSEPH MILLER MD
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Gender | Male
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 4440 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-2600
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Country | US
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Telephone | 708-684-5375
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Fax |
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Provider Business Mailing Address
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Address Line | 4440 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-2600
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Country | US
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Telephone | 708-684-5375
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036166518
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License Number State | IL
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