Basic Information
| Provider Information | |||||||||
| NPI: | 1639203516 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHARLES E MILLER M D SC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27555 DIEHL RD | ||||||||
| Address2: | ENTRANCE B | ||||||||
| City: | WARRENVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605553849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6306463884 | ||||||||
| FaxNumber: | 6305480276 | ||||||||
| Practice Location | |||||||||
| Address1: | 1900 EAST GOLF RD. | ||||||||
| Address2: | SUITE L125 | ||||||||
| City: | SCHAUMBURG | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60173 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475931040 | ||||||||
| FaxNumber: | 8475179294 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2007 | ||||||||
| LastUpdateDate: | 07/20/2007 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | CHARLES | ||||||||
| AuthorizedOfficialMiddleName: | E. | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 8475931040 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VE0102X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Reproductive Endocrinology |
No ID Information.