Provider Demographics
NPI:1356491732
Name:MILOS, DEAN R (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:R
Last Name:MILOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 N YORK RD
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2318
Mailing Address - Country:US
Mailing Address - Phone:630-834-6055
Mailing Address - Fax:630-834-3128
Practice Address - Street 1:332 N YORK RD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2318
Practice Address - Country:US
Practice Address - Phone:630-834-6055
Practice Address - Fax:630-834-3128
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL03645876207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036045867Medicaid
IL036045867Medicaid
IL245180Medicare PIN