Individual
CANDICE MARIE MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RVT, RDCS, ARDMS, RT
Contact information
Practice address
475 BROWN BLVD STE 103, BOURBONNAIS, IL 60914-2325
(815) 937-7962
(815) 936-8650
Mailing address
365 CONESTOGA DR, CHESTERTON, IN 46304-1559
(219) 617-8218
(502) 775-8345
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
5360024302
IN
174H00000X
Health Educator
98113
IN
207V00000X
Obstetrics & Gynecology Physician
98113
IN
208000000X
Pediatrics Physician
98113
IN
2085U0001X
Diagnostic Ultrasound Physician
Primary
98113
IN
247100000X
Radiologic Technologist
98113
IN
2471C1101X
Cardiovascular-Interventional Technology Radiologic Technologist
98113
IN
2471S1302X
Sonography Radiologic Technologist
98113
IN
2471V0105X
Vascular Sonography Radiologic Technologist
98113
IN
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
98113
IN
Other
Enumeration date
03/09/2020
Last updated
11/29/2022
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