Organization
NEPHROLOGY AND HYPERTENSION CONSULTANTS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH MILLER MD (PHYSICIAN/OWNER)
(813) 890-8004
Entity
Organization
Contact information
Practice address
1480 RENAISSANCE DR, SUITE 211, PARK RIDGE, IL 60068-1332
(813) 890-8004
(813) 290-9691
Mailing address
1480 RENAISSANCE DR, SUITE 211, PARK RIDGE, IL 60068-1332
(813) 890-8004
(813) 290-9691
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036051280
IL
2080P0210X
Pediatric Nephrology Physician
036051280
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051280
—
IL
Enumeration date
06/05/2008
Last updated
11/17/2009
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