Michael Miller

NPI #1629610902 in Blue Island, Illinois

Provider Information

NPI Number: 1629610902
Entity Type: Individual
Name: Michael Miller
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician
Enumeration Date: Oct 8, 2019
Last Updated: Oct 8, 2019

Practice Location

Address: 12554 FAIRVIEW AVE APT 1F
City: Blue Island
State: Illinois
ZIP Code: 60406-1781
Phone: (708) 921-4135

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician	374700000X	Primary

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