Provider Demographics
NPI:1710944954
Name:MILLEN, STEVEN J (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:MILLEN
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 1:11035 W FOREST HOME AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130-2541
Mailing Address - Country:US
Mailing Address - Phone:414-529-3215
Mailing Address - Fax:414-529-3214
Practice Address - Street 1:11035 W FOREST HOME AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:HALES CORNERS
Practice Address - State:WI
Practice Address - Zip Code:53130-2541
Practice Address - Country:US
Practice Address - Phone:414-529-3215
Practice Address - Fax:414-529-3214
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18990207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30251900Medicaid
B55106Medicare UPIN
WI30251900Medicaid