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Individual

DR. AMANDA CHERIE MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1401 E STATE ST, ROCKFORD, IL 61104-2315
(414) 290-6720
(414) 290-6755
Mailing address
111 E WISCONSIN AVE, SUITE 2000, MILWAUKEE, WI 53202-4815
(414) 290-6720
(414) 290-6755

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036.129777
IL
207P00000X
Emergency Medicine Physician
5101017721
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036129777
IL
05
1376704320
WI
01
P01098760
MEDICARE RAILROAD
IL
Enumeration date
06/23/2008
Last updated
12/02/2014
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