Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 036088825 | IL |
Y | 208200000X | Surgeon | 036088825 | IL |
Y | 208600000X | Surgeon | 036088825 | IL |
NPI | 1447315270 |
---|---|
Provider Name | James M Millis |
First Address | Chicago, IL 60637-1447 |
Second Address | Burr Ridge, IL 60527-7594 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2006 |
Last Update Date | 21/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036088825 | (05) | IL |