Individual
JOHN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7725 N KNOXVILLE AVE, PEORIA, IL 61614-2079
(309) 692-6088
Mailing address
5100 RELIABLE PKWY, CHICAGO, IL 60686-0001
(309) 672-4809
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008439
HEALTH ALLIANCE
IL
05
—
0360690561
—
IL
01
—
472315
HEALTHLINK
IL
01
—
7215059
BCBS PPO
IL
01
—
IL0107
JOHN DEERE
IL
Enumeration date
08/01/2006
Last updated
07/08/2007
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