Individual
NICOLAS MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15255 KENMARE CIR, MANHATTAN, IL 60442-1441
(815) 342-8682
Mailing address
15255 KENMARE CIR, MANHATTAN, IL 60442-1441
(815) 342-8682
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/01/2021
Last updated
02/29/2024
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