Individual
RODNEY LEE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
220 S PARK AVE, 3RD FLOOR, HERRIN, IL 62948-3612
(618) 942-2002
(618) 942-4477
Mailing address
1239 E MAIN ST, P O BOX 3988, CARBONDALE, IL 62901-3114
(618) 457-5200
(618) 351-4821
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-106959
IL
208600000X
Surgery Physician
Primary
036106959
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036106959
—
IL
01
—
1750382396
BCBS OF IL
IL
01
—
3932056
BCBS
IL
05
—
7100114770
—
KY
01
—
721089
AETNA
IL
Enumeration date
08/04/2005
Last updated
01/23/2013
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