Provider Demographics
NPI:1588858864
Name:ADAM W. MILIK, MD,SC
Entity Type:Organization
Organization Name:ADAM W. MILIK, MD,SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:MILIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-534-2000
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:MONEE
Mailing Address - State:IL
Mailing Address - Zip Code:60449-0190
Mailing Address - Country:US
Mailing Address - Phone:708-534-2000
Mailing Address - Fax:708-534-2001
Practice Address - Street 1:4854 W COURT ST
Practice Address - Street 2:
Practice Address - City:MONEE
Practice Address - State:IL
Practice Address - Zip Code:60449-8988
Practice Address - Country:US
Practice Address - Phone:708-534-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036098612207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14D1073833OtherCLIA
ILDH0544OtherRAILROAD MEDICARE
ILIL7448Medicare PIN
IL215635Medicare PIN