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NPI Code Detail

MEDICARE: DR. WAIDE LEE MILLER D.C.

MEDICARE: DR. WAIDE LEE MILLER D.C.
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
1111N00000XChiropractorIL
2111NN0400XNeurology ChiropractorIL
3111NR0400XRehabilitation ChiropractorIL
4111NS0005XSports Physician ChiropractorIL
5111NT0100XThermography ChiropractorIL
6111NX0800XOrthopedic ChiropractorIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
104932265OTHERIDBLUE CROSS BLUE SHIELD ID

General Provider Information

NPI Number : 1659497790
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WAIDE LEE MILLER D.C.
Provider Business Mailing Address
First Line : 61 S OLD RAND RD
Second Line : SUITE 104
City : LAKE ZURICH
State : IL
Zip : 60047-3127
Country : US
Telephone Number : 847-540-1439
Fax Number : 847-540-6407
Provider Business Practice Location Address
First Line : 61 S OLD RAND RD
Second Line : SUITE 104
City : LAKE ZURICH
State : IL
Zip : 60047-3127
Country : US
Telephone Number : 847-540-1439
Fax Number : 847-540-6407
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 09/11/2025

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