Provider Demographics
NPI:1578576724
Name:MILLER, MICHAEL L (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:255 E CHICAGO AVENUE
Mailing Address - Street 2:LURIE CHILDREN'S HOSPITAL #50 DIVISION OF RHEUMATOLOGY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:312-227-6270
Mailing Address - Fax:312-227-9417
Practice Address - Street 1:255 E CHICAGO AVENUE
Practice Address - Street 2:LURIE CHILDREN'S HOSPITAL #50 DIVISION OF RHEUMATOLOGY
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-227-6270
Practice Address - Fax:312-227-9417
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
IL0360549332080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036054933Medicaid
ILL22213Medicare ID - Type Unspecified
IL036054933Medicaid