Individual
JAY JAMES MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
107 N REGENCY DR, SUITE 2, BLOOMINGTON, IL 61701
(309) 665-0900
(309) 665-0901
Mailing address
107 N REGENCY DR, SUITE 2, BLOOMINGTON, IL 61701
(309) 665-0900
(309) 665-0901
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036-108046
IL
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
036-108046
IL
Other
Enumeration date
09/21/2006
Last updated
01/03/2013
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