MEDICARE: MILLER EYE CENTER LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier	332H00000X	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0462880001	OTHER	IL	DMERC

General Provider Information

NPI Number	:	1619063013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLER EYE CENTER LTD

Provider Business Mailing Address
First Line	:	PO BOX 7267
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61126-7267
Country	:	US
Telephone Number	:	815-226-1500
Fax Number	:	815-484-9600

Provider Business Practice Location Address
First Line	:	2995 EASTROCK DR
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61109-1737
Country	:	US
Telephone Number	:	815-226-1500
Fax Number	:	815-484-9600

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD A MILLER
Credential	:	MD
Telephone Number	:	815-226-1500

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/08/2011

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Directions to “MILLER EYE CENTER LTD ” Practice Location

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