Miller, Glenn A
Miller, Glenn A is an individual health care provider with primary practice located at 10200 West Main Street Signal Hill Medical Building, Belleville IL 62223-1495. He recently has only one registered license in Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, which is considered as his primary health care specialty. Miller, Glenn A can be contacted via phone (618) 397-2464.Contact Information
Primary practice address
10200 West Main Street Signal Hill Medical Building
Belleville IL 62223-1495
Phone: (618) 397-2464
Fax: (618) 398-4450
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 19A13884 | Illinois |
Profile Details
| NPI number | 1922198118 |
|---|---|
| LBN Legal business name | Miller, Glenn A |
| Credentials | DDSMS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 16th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922198118 | NPPES |
| Illinois | Other | 80115934 | ILLINOIS BLUE SHIELD |
| Illinois | Other | 679927 | ILLINOIS BLUE SHIELD |
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