Individual
MICHAEL MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12554 FAIRVIEW AVE APT 1F, BLUE ISLAND, IL 60406-1781
(708) 921-4135
Mailing address
12554 FAIRVIEW AVE APT 1F, BLUE ISLAND, IL 60406-1781
(708) 921-4135
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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