Basic Information
Provider Information
NPI: 1912529199
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILLER
FirstName: RASMEET
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3655 N TROY ST APT 2
Address2:  
City: CHICAGO
State: IL
PostalCode: 606184515
CountryCode: US
TelephoneNumber: 9175473477
FaxNumber:  
Practice Location
Address1: 1127 N OAKLEY BLVD FL 2
Address2:  
City: CHICAGO
State: IL
PostalCode: 606223507
CountryCode: US
TelephoneNumber: 3127702040
FaxNumber: 7733847433
Other Information
ProviderEnumerationDate: 05/11/2020
LastUpdateDate: 05/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X125.075681ILY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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