Provider Demographics
NPI:1447239173
Name:MILLAR, MARGARET SIDLES (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:SIDLES
Last Name:MILLAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 JOHN DEERE RD
Mailing Address - Street 2:STE 401
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-6869
Mailing Address - Country:US
Mailing Address - Phone:309-779-4950
Mailing Address - Fax:309-779-4905
Practice Address - Street 1:600 JOHN DEERE RD
Practice Address - Street 2:STE 401
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265
Practice Address - Country:US
Practice Address - Phone:309-779-4950
Practice Address - Fax:309-779-4905
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173000000X
IL036-078142207Q00000X
IL036.078142207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No173000000XOther Service ProvidersLegal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL00009683OtherRR MEDICARE
IL0360781422Medicaid
IL200345OtherILLINOIS MEDICARE
IL8132014OtherILLINOIS BLUE
ILF400293098OtherMEDICARE PTAN
IA1447239173Medicaid
IL200345001Medicare PIN