Provider Demographics
NPI:1770502494
Name:MILLER, GAIL D (MD)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:D
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9944 S ROBERTS RD
Mailing Address - Street 2:STE 107
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-1555
Mailing Address - Country:US
Mailing Address - Phone:708-430-2020
Mailing Address - Fax:708-430-2142
Practice Address - Street 1:9944 S ROBERTS RD
Practice Address - Street 2:STE 107
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-1555
Practice Address - Country:US
Practice Address - Phone:708-430-2020
Practice Address - Fax:708-430-2142
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036056923208M00000X
IL207V00000X207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL6512OtherPTAN
IL036056923Medicaid