Provider Demographics
NPI:1508859059
Name:MILLER, STEVEN B (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:B
Last Name:MILLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9933 LAWLER AVE
Mailing Address - Street 2:SUITE 315
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3703
Mailing Address - Country:US
Mailing Address - Phone:847-675-3400
Mailing Address - Fax:847-725-0070
Practice Address - Street 1:9933 LAWLER AVE
Practice Address - Street 2:SUITE 315
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3703
Practice Address - Country:US
Practice Address - Phone:847-675-3400
Practice Address - Fax:847-725-0070
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-004990213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016-004990Medicaid
IL016-004990Medicaid
590590Medicare ID - Type Unspecified
U81286Medicare UPIN