Basic Information
Provider Information
NPI: 1063820264
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILINI
FirstName: G.
MiddleName: GREGORY
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: 215 SHUMAN BLVD
Address2: STE. 401
City: NAPERVILLE
State: IL
PostalCode: 605638458
CountryCode: US
TelephoneNumber: 6303035380
FaxNumber: 9783136824
Practice Location
Address1: 621 SW JOHNSON AVE
Address2: STE A
City: BURLESON
State: TX
PostalCode: 760285833
CountryCode: US
TelephoneNumber: 8174477930
FaxNumber: 8174477961
Other Information
ProviderEnumerationDate: 07/31/2014
LastUpdateDate: 07/31/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237700000X  Y Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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