Miller, Roger L
Miller, Roger L is an individual health care provider with primary practice located at 2300 N Rockton Ave Ste 304, Rockford IL 61103-3619. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Miller, Roger L can be contacted via phone (815) 964-3333.Contact Information
Primary practice address
2300 N Rockton Ave Ste 304
Rockford IL 61103-3619
Phone: (815) 964-3333
Fax: (815) 864-3331
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | Illinois | |
| Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | Illinois |
Profile Details
| NPI number | 1912903899 |
|---|---|
| LBN Legal business name | Miller, Roger L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2005 |
| Last updated | Dec 17th, 2007 - about 18 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 | 1912903899 | NPPES |
| Illinois | Other | 194361 | PERSONAL CARE |
| Illinois | MEDICAID | 036062833 2 | PERSONAL CARE |
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