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Individual

DR. KIMBERLY M BATTLE-MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3825 HIGHLAND AVE STE 5B, DOWNERS GROVE, IL 60515-1551
(630) 963-9963
(630) 963-9667
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
036089483
IL
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
Primary
036089483
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01635624
BCBS PROVIDER NUMBER
IL
01
036089483
LICENSE #
IL
05
036089483
IL
01
206147
MEDICARE PTAN (GROUP)
IL
01
F400192396
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
09/07/2005
Last updated
05/19/2022
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