Organization
IOWA ILLINOIS PAIN CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY MILLER M.D. (PRESIDENT)
(563) 424-0512
Entity
Organization
Contact information
Practice address
600 N COLLEGE AVE, GENESEO, IL 61254-1091
(309) 944-6431
Mailing address
PO BOX 689, LAKE FOREST, IL 60045-0689
(563) 324-8160
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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