Provider Demographics
NPI:1649377011
Name:MILET, JOLANTA (DC)
Entity type:Individual
Prefix:DR
First Name:JOLANTA
Middle Name:
Last Name:MILET
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TIFFANY PTE
Mailing Address - Street 2:G2
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108
Mailing Address - Country:US
Mailing Address - Phone:630-582-1986
Mailing Address - Fax:630-582-9707
Practice Address - Street 1:1 TIFFANY PT
Practice Address - Street 2:G2
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2936
Practice Address - Country:US
Practice Address - Phone:630-582-1986
Practice Address - Fax:630-582-9707
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04505042OtherBCBS
IL986590Medicare ID - Type Unspecified
IL04505042OtherBCBS