Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 36-109737 | IL |
NPI | 1447261524 |
---|---|
Provider Name | Jennifer Lynn Miller |
First Address | Chicago, IL 60611-2991 |
Second Address | Chicago, IL 60649-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 16/10/2012 |