Individual
CAROL MILLER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
C-PNP
Contact information
Practice address
7801 N KNOXVILLE AVE, PEORIA, IL 61614-2076
(309) 692-6088
Mailing address
5100 RELIABLE PARKWAY, CHICAGO, IL 60686-0001
(309) 692-6088
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
20900797
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023683
HEALTH ALLIANCE
IL
01
—
472310
HEALTHLINK
IL
01
—
7215059
BCBS PPO
IL
01
—
IL01Q2
JOHN DEERE
IL
Enumeration date
06/12/2006
Last updated
07/08/2007
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