Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 038.010586 | IL |
Y | 213ER0200X | Radiology | 038.010586 | IL |
NPI | 1518118280 |
---|---|
Provider Name | Heather Miley |
First Address | Lisle, IL 60532-1455 |
Second Address | Lisle, IL 60532-1455 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2008 |
Last Update Date | 14/11/2008 |