Basic Information
| Provider Information | |||||||||
| NPI: | 1336724145 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WILLIAM P. MCMILLER MD MPH PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 706 | ||||||||
| Address2: | |||||||||
| City: | OAK PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 603030706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7084340336 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4909 W DIVISION ST STE 106A | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606513161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7084340336 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2021 | ||||||||
| LastUpdateDate: | 03/12/2021 | ||||||||
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| AuthorizedOfficialLastName: | MCMILLER | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7084340336 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 03/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.