Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 036066686 | IL |
N | 207VE0102X | Reproductive Endocrinologist | 036066686 | IL |
NPI | 1114010097 |
---|---|
Provider Name | Dr. Charles Edward Miller |
First Address | Naperville, IL 60540-7429 |
Second Address | Naperville, IL 60540-7429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 31/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2233275 | BCBS OF IL (01) | IL |
E11107 | (02) |